甲状腺微小癌超声征象的多元回归分析

Ultrasonic diagnosis of thyroid microcarcinoma by multiple regression analysis

目的运用多元回归筛选鉴别甲状腺微小癌的敏感声像图特征,提高超声诊断甲状腺微小癌的准确率。方法回顾分析经病理确诊的255个直径≤10 mm的甲状腺小结节声像图,对各超声特征进行统计学赋值,并进行logistic多元回归分析。结果经Logistic逐步回归分析,8个超声特征全部引入方程,其危险度按OR值大小排列为:含有微钙化、低回声、结节内不含液性成分、临近被膜受侵、2或3级血流、边缘不规则、边界不清及内部回声均匀。结论①以超声特征诊断甲状腺结节的Logistic回归模型有助于鉴别甲状腺微小癌;②甲状腺微小癌多数表现为较均匀的低回声;③出现囊变区或结节内呈筛网状的多数是良性结节;④相邻甲状腺被膜受侵在微小癌中并不罕见,一旦发现,鉴别诊断意义较大。

Objective To investigate the sonogram features for the differential diagnosis of thyroid microcarcinomo by multiple regression analysis, and to improve the accurate rate of differential diagnosis of thyroid microcarcinoma by ultrasound. Methods Two hundred and fifty five thyroid nodules （ ≤ 10 mm） were confirmed by pathology, their sonogram features were analyzed retrospectively, the results was analyzed by multiple stepwise regression analysis. Results With stepwise regression analysis, 8 ultrasonic features were enrolled in equations, their risk rank was disposed by OR value as follows： microealcification, low echo - level, no liquid composition in nodus, invasion adjacent capsule of thyroid, grade 2 or grade 3 blood flow, irregular edge, obscure boundary and homogeneous internal echo. Conclusion ①The Logistic model can help differential diagnosis of throid mierocarcinoma. ②Most of thyroid microcarcinoma shows internal homogeneous low echo - level.③Cystie area and internal mesh is protective sonogram feature. ④Invasion adjacent capsule of thyroid is not rare, and its discovery has important significance for differential diagnosis of thyroid mieroeareinomo.