摘要
Objective:To establish a nomogram model based on elastic imaging parameters and ultrasound image features, and evaluate its predictive value in central lymph node metastasis (CLNM) in papillary thyroid carcinoma (PTC) .Methods:The clinical data of 168 patients (the research group) with papillary thyroid carcinoma who underwent thyroid surgery in our hospital from Jan. 2019 to Dec. 2021 were retrospectively collected, including gender, age, ultrasound elastography parameters (elasticity ratio, blue area ratio), and ultrasound examination indicators (nodule diameter, nodule number, internal echo, border, edge, aspect ratio, microcalcification, capsule invasion). Another 150 patients who underwent thyroid surgery in our hospital during the same period were selected as the validation group.According to the results of postoperative pathological examination, the the research group were divided into two groups: 64 cases (38.10%) of CLNM and 104 cases (61.90%) of non-CLNM. Binary logistic regression analysis was used to explore the influencing factors of CLNM in PTC patients, and a nomogram model based on elastic imaging parameters and ultrasound image features was established. The nomogram model was drawn to predict the receiver operating characteristic (ROC) curve of CLNM in PTC patients.Results:There were statistically significant differences in nodule diameter, edge, microcalcification, capsule invasion, blue area ratio, and elasticity ratio ( P<0.05). Most of the nodules in the CLNM group were ≥10 mm in diameter, with uneven margins, an aspect ratio of <1, microcalcifications and capsular invasion. Logistic regression analysis showed that nodule diameter, capsule invasion, blue area ratio and elastic ratio were risk factors for CLNM ( P<0.05). The AUC of the combined detection was 0.857 (0.777-0.937), and the sensitivity and specificity were 78.1% and 86.5%, respectively, and the AUC and sensitivity were significantly higher than the individual detection of each index ( P<0.05). In the research group, the sensitivity and specificity of the ultrasound parameter prediction model in predicting CLNM were 81.25% (52/64) and 84.62% (88/104), respectively. In the validation group, the sensitivity and specificity of the ultrasound parameter prediction model in predicting CLNM were 79.17% (38/48) and 85.29% (87/102), respectively. Conclusion:Elastography parameters (blue area ratio, elasticity ratio) and ultrasound image features (nodule diameter, capsular invasion) are the influencing factors of CLNM in PTC patients, and the combined prediction based on the above four indicators has good application value.
摘要
Objective:To study the evaluation of left ventricular myocardial function in patients with chronic renal failure by cardiac magnetic resonance feature tracking technique.Methods:Thirty patients with chronic renal failure (chronic renal failure group) who were treated in Jinhua Central Hospital of Zhejiang Province from June 2018 to June 2019 and 30 adult volunteers (healthy control group) who were examined at the same period were enrolled. The cardiac movie sequence was obtained by using Phillips Acheva 3.0 T CMR imaging equipment. The tissue tracking tool in CVI42 software was used to analyze the myocardial strain of the subjects, and the levels of left ventricular ejection fraction (LVEF), end diastolic volume (EDV), end systolic volume (ESV), apoptotic volume (AV), global longitudinal strain (GL), global circumferential strain (GC) and global radial strain (GR) were detected and compared between two groups.Results:The level of EDV in chronic renal failure group was higher than that in healthy control group: (132.3 ± 18.5) ml vs. (111.5 ± 15.1) ml, the level of LVEF in chronic renal failure group was lower than that in healthy control group: (62.41 ± 2.10)% vs. (67.30 ± 3.92)%, and the differences were statistically significant ( P<0.01). The levels of GL, GC and GR in chronic renal failure group were lower than those in healthy control group: (-16.3 ± 3.1)% vs. (-11.1 ± 4.1)%,(-17.5 ± 2.9)% vs. (-13.7 ± 4.7)% and (36.5 ± 9.5)% vs. (46.3 ± 8.4)%, and the differences were statistically significant ( P<0.01). When b = 300, 500 and 800 s/mm 2, the apparent diffusion coefficient (ADC) value of different clinical stages in healthy control group and chronic renal failure group were compared, and the differences were statistically significant ( P<0.01). When the clinical stage of chronic renal failure was higher, its ADC value was lower gradually. Conclusions:Cardiac magnetic resonance feature tracking technology can accurately and effectively evaluate the changes of left ventricular myocardial function in patients with chronic renal failure.