常规超声及超声弹性成像在甲状腺良恶性结节鉴别诊断的价值比较

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1、授予单位代码10089学号或申请号13363HebeiMedicalUniversity硕士学位论文科学学位常规超声及超声弹性成像在甲状腺良恶性结节鉴别诊断的价值比较作者姓名：常涛导师：康立清教授专业：影像医学与核医学二级学院：沧州市中心医院2014年03月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师（或指导小组）的指导下，由本人独立完成。本学位论文研究所获得的研究成果，其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用。凡发表与学位论文主要内容相关的论文，第一署名为单位河北医科大学

2、，试验材料、原始数据、申报的专利等知识产权均归河北医科大学所有。否则，承担相河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注和致谢等内容外，文中不包含其他人己经发表或撰写的研究成果，指导教师对此进行了审定。本论文由本人独立撰写，文责自负。目录中文摘要·············································································1英文摘要······························

3、···············································4研究论文常规超声及超声弹性成像在甲状腺良恶性结节鉴别诊断的价值比较前言·············································································9材料与方法····································································10结果·····························

4、················································14附图·············································································18附表·············································································26讨论·····················································

5、························34结论·············································································41参考文献·······································································41综述超声弹性成像在甲状腺良恶性结节鉴别诊断中的应用进展·····46致谢···············································

6、····································55个人简历·············································································56中文摘要常规超声及超声弹性成像在甲状腺良恶性结节鉴别诊断的价值比较摘要目的：评价超声弹性成像（ultrasoundelastography，UE）弹性评分(elasticityscore，ES)和弹性应变比值(strainratio，SR)及常规超声（conventionalultrasou

7、nd，CU）对甲状腺良恶性结节的鉴别诊断价值，并探讨比较CU、ES、SR、三者联合应用四组检查方法对甲状腺良恶性结节的鉴别诊断效能的差异。方法：选取2013年6月~2014年11月在我院接受UE和CU检查并接受手术切除、经病理证实的甲状腺结节患者98例，共108个结节，以病理组织学为金标准，回顾性分析CU、UE对甲状腺结节的定性诊断的准确性，并重点分析误诊病例的病理学表现，探索误诊原因及联合多种技术减少误诊的可能性。将结节按大小分成＜1cm，1~2cm，＞2cm三组。CU诊断标准参考ParkW提出的甲状腺影像学报告及数据系统(T

8、hyroidimagingreportinganddatasystem，TI-RADS)，其诊断标准为1~3级为良性，4~5级为恶性。ES评分诊断标准采用5分法，其中0~2分评为甲状腺良性结节，3~4分评为甲状腺恶性结节。构建CU、ES及SR的受试者工作特征曲线