回顾并分析2018年1月2019年7月于南京医科大学第一附属医院行超声检查时发现的实性为主的甲状腺结节,并经手术或穿刺标本病理学检查证实的97例患者,共97个结节,其中良性结节40个,恶性结节57个。整理分析结节的二维及彩色多普勒血流显像特征,比较两组结节基本特征差异,然后基于偏最小二乘-判别分析法(partial least squares-discriminant analysis,PLS-DA)和logistic回归分析方法建立结节良恶性判别模型。
结果:
利用Spearman相关性分析及逐步回归分析方法(Stepwise)对以实性为主的甲状腺结节特征变量进行分析,发现年龄、囊性是否偏心、强回声、边缘、形态、纵横比、甲状腺整体回声以及囊性成分分布等8个特征变量与以实性为主甲状腺结节良恶性显著相关。基于这8个特征变量构建数学模型,PLS-DA的真阳性预测值和真阴性预测值分别是92.9%和96.6%,logistic回归分析的真阳性预测值和真阴性预测值分别是92.0%和88.8%。此外,基于PLS-DA的受试者工作特征(receiver operating characteristic,ROC)曲线的曲线下面积(area under curve,AUC)值为0.947,显著大于logistic回归分析的0.904。
To investigate the application of ultrasound image and mathematical models in the diagnosis of benign and malignant partially cystic thyroid nodules.
Methods:
A retrospective study was conducted in 97 patients with thyroid nodules from Jan. 2018 to J
ul. 2019 in the First Affiliated Hospital of Nanjing Medical University. Each gray scale value of the 2-D ultrasound image and color Doppler flow imaging of thyroid nodule was read. There existed totally 97 nodes
including 40 benign and 57 malignant partially cystic thyroid nodules
respectively. The malignant partially-cystic thyroid nodules were confirmed by surgery and pathology
and benign partially-cystic thyroid nodules were confirmed by fine needle aspiration biopsy (FNAB). The ultrasonic features of nodules were analyzed. Then based on the variables of ultrasonic features with significant correlation
the partial least squares-discriminant analysis (PLS-DA) and logistic regression were used to diagnose partially cystic thyroid nodules.
Results:
Based on Spearman correlation analysis and Stepwise regression analysis
eight variables from ultrasonic features were selected
including age
position of cystic portion
calcification
margin
shape
orientation
and distribution of cystic components (limited or not)
and whether the thyroid is accompanied by diffuse lesions. According to the selected variables
the true positive and negative rates of PLS-DA were 92.9% and 96.6%
respectively. The true positive and negative rates of logistic regression were 92.0% and 88.8%
respectively. The area under curve (AUC) of PLS-DA was 0.947
which was much higher than that of logistic regression (0.904).
Conclusion:
The methods of PLS-DA and logistic regression coupled with ultrasound image could be used for diagnosis ofbenign and malignant partially cystic thyroid nodules. PLS-DA seems to be more powerful than ogistic regression.
Multivariate analysis of ultrasonographic characteristics for differentiating benign and malignant BethesdaⅢ category thyroid nodules
Diagnostic value of contrast-enhanced ultrasound combined with fine-needle aspiration biopsy in thyroid TI-RADS 4 nodules
ATA guidelines, Kwak TI-RADS, ACR TI-RADS, and C TI - RADS are compared for the diagnostic performance of thyroid nodules in children
Diagnostic value of conventional ultrasound combined with contrast-enhanced ultrasound in cystic solid thyroid nodule
Feasibility study on optical navigation assisted cryoablation of thyroid nodules
Related Author
XIN Hongbing
ZHANG Lijuan
WANG Hong
GUO Shan
FEI Zhengdong
LI Siqi
YANG Bin
ZHOU Yajun
Related Institution
Department of Ultrasound, The Fourth Affiliated Hospital of Nanjing Medical University
Department of Ultrasound, Jinling Clinical Medical College, Nanjing Medical University, General Hospital of the Eastern Theater of the Chinese People's Liberation Army
Department of Ultrasound, Tangshan Central Hospital
North China University of Science and Technology
Department of Ultrasound, Tangshan Gongren Hospital