目的·评估超声甲状腺影像报告与数据系统(thyroid imaging-reporting and data system,TI-RADS)联合三维剪切波弹性成像(three-dimensional shear wave elastography,3D-SWE)技术对甲状腺微小癌的诊断价值。方法·回顾性分析2...目的·评估超声甲状腺影像报告与数据系统(thyroid imaging-reporting and data system,TI-RADS)联合三维剪切波弹性成像(three-dimensional shear wave elastography,3D-SWE)技术对甲状腺微小癌的诊断价值。方法·回顾性分析2017年6月—2018年1月于上海交通大学医学院附属仁济医院超声医学科行超声检查的甲状腺结节患者66例(共67个结节,结节最大直径5.0~10.0 mm,为常规TI-RADS 4~5级)。所有甲状腺结节经常规超声检查后,均采用TI-RADS分级进行评估,并行3D-SWE技术检查、细针穿刺活检及BRAFV600E基因检测。所有结节依据手术病理或细针穿刺细胞学联合BRAFV600E基因突变检测结果分为良性组及恶性组,计算由3D-SWE区分的甲状腺良、恶性结节的阈值,并应用病灶杨氏模量参数进一步调整分级成为联合TI-RADS分级(即经常规超声联合3D-SWE技术调整后的联合TI-RADS分级),用于结节的良、恶性检测。结果·67个甲状腺结节中,恶性组38个,良性组29个。以三维矢状面最大杨氏模量(three-dimensional maximum Young's modulus in sagittal plane,3D-S-Emax)为诊断指标,鉴别甲状腺结节良恶性的阈值、曲线下面积(area under the curve,AUC)、灵敏度、特异度和准确度分别为24.6 kPa、0.683、65.8%、65.5%和65.7%。采用常规TI-RADS分级和联合TI-RADS分级分别对甲状腺结节行良恶性鉴别诊断发现,AUC分别为0.794和0.801且差异无统计学意义;而敏感度、特异度和准确度分别为63.2%、82.8%、71.6%以及86.8%、69.0%、79.1%,仅敏感度间差异具有统计学意义(P=0.004)。结论·常规超声联合3D-SWE技术调整的联合TI-RADS分级与常规TI-RADS分级虽然对甲状腺微小癌具有相似的诊断价值,但前者具有较高的诊断敏感度及较低的漏诊率。展开更多
Based on the general requirements of the coordinated development of"ecological livable"and"affluent life"in the rural revitalization strategy,the evaluation index system of desertification control ...Based on the general requirements of the coordinated development of"ecological livable"and"affluent life"in the rural revitalization strategy,the evaluation index system of desertification control was constructed,the interaction between desertification control and regional social economy and the internal space-time coordination mechanism were explored,and the quality of desertification control and its coordination degree with regional economic development were quantitatively analyzed.The decoupling mechanism of desertification governance society economy system were analyzed,and the high level for the government to promote desertification governance,constructing ecological economy coordinated development pattern to provide decision basis to Xizang desertification governance-social economic system interaction and coupling coordination development as the research object,introducing the coupling decoupling model to measure the coupling coordination model and system coordination and decoupling decoupling.Desertification control in Xizang shows a trend of gradual improvement,but the overall level is still not high and there is a lot of room for optimization.The coupling coordination degree of desertification control-social and economic system is in a steady fluctuation trend,rising from D value less than 0.55 in 2004 to 0.87 in 2018,in a state of coordinated development(good),and grey prediction analysis shows that D value is in a continuous rise.The coupling coordination degree of the six prefecture-level cities in Xizang and Ngari region is different in time and space,but the overall development trend is coordinated.The development index of desertification control and the socio-economic development index show the interaction of strong decoupling,strong negative decoupling and weak decoupling,and there are interaction effects of desertification control,economic development and social development at different scales.展开更多
文摘目的·评估超声甲状腺影像报告与数据系统(thyroid imaging-reporting and data system,TI-RADS)联合三维剪切波弹性成像(three-dimensional shear wave elastography,3D-SWE)技术对甲状腺微小癌的诊断价值。方法·回顾性分析2017年6月—2018年1月于上海交通大学医学院附属仁济医院超声医学科行超声检查的甲状腺结节患者66例(共67个结节,结节最大直径5.0~10.0 mm,为常规TI-RADS 4~5级)。所有甲状腺结节经常规超声检查后,均采用TI-RADS分级进行评估,并行3D-SWE技术检查、细针穿刺活检及BRAFV600E基因检测。所有结节依据手术病理或细针穿刺细胞学联合BRAFV600E基因突变检测结果分为良性组及恶性组,计算由3D-SWE区分的甲状腺良、恶性结节的阈值,并应用病灶杨氏模量参数进一步调整分级成为联合TI-RADS分级(即经常规超声联合3D-SWE技术调整后的联合TI-RADS分级),用于结节的良、恶性检测。结果·67个甲状腺结节中,恶性组38个,良性组29个。以三维矢状面最大杨氏模量(three-dimensional maximum Young's modulus in sagittal plane,3D-S-Emax)为诊断指标,鉴别甲状腺结节良恶性的阈值、曲线下面积(area under the curve,AUC)、灵敏度、特异度和准确度分别为24.6 kPa、0.683、65.8%、65.5%和65.7%。采用常规TI-RADS分级和联合TI-RADS分级分别对甲状腺结节行良恶性鉴别诊断发现,AUC分别为0.794和0.801且差异无统计学意义;而敏感度、特异度和准确度分别为63.2%、82.8%、71.6%以及86.8%、69.0%、79.1%,仅敏感度间差异具有统计学意义(P=0.004)。结论·常规超声联合3D-SWE技术调整的联合TI-RADS分级与常规TI-RADS分级虽然对甲状腺微小癌具有相似的诊断价值,但前者具有较高的诊断敏感度及较低的漏诊率。
基金supported by the Beijing Social Science Foundation Project(Grant No.18YJB011)the Ministry of Education Humanities and Social Science Research Fund for Youth Project(Grant No.20YJA790059)+2 种基金the National Social Science Foundation of China(Grant No.20FGLB022)the General Project of National Social Science Foundation of China(Grant No.19BGL052)the Innovation and Entrepreneurship Project of Beijing Forestry University(Grant No.X202110022111).
文摘Based on the general requirements of the coordinated development of"ecological livable"and"affluent life"in the rural revitalization strategy,the evaluation index system of desertification control was constructed,the interaction between desertification control and regional social economy and the internal space-time coordination mechanism were explored,and the quality of desertification control and its coordination degree with regional economic development were quantitatively analyzed.The decoupling mechanism of desertification governance society economy system were analyzed,and the high level for the government to promote desertification governance,constructing ecological economy coordinated development pattern to provide decision basis to Xizang desertification governance-social economic system interaction and coupling coordination development as the research object,introducing the coupling decoupling model to measure the coupling coordination model and system coordination and decoupling decoupling.Desertification control in Xizang shows a trend of gradual improvement,but the overall level is still not high and there is a lot of room for optimization.The coupling coordination degree of desertification control-social and economic system is in a steady fluctuation trend,rising from D value less than 0.55 in 2004 to 0.87 in 2018,in a state of coordinated development(good),and grey prediction analysis shows that D value is in a continuous rise.The coupling coordination degree of the six prefecture-level cities in Xizang and Ngari region is different in time and space,but the overall development trend is coordinated.The development index of desertification control and the socio-economic development index show the interaction of strong decoupling,strong negative decoupling and weak decoupling,and there are interaction effects of desertification control,economic development and social development at different scales.
