| 摘要: |
| 目的：评价超声检测声带运动在诊断甲状腺癌术前声带麻痹中的价值。方法：35例于我院经穿刺或手术病理检查证实为甲状腺癌且出现声音嘶哑的患者,先后分别行声带区超声检查和喉镜检查。通过对声带及杓状软骨被动和主动运动的超声观察,对声带进行1~3级分级(1级为声带运动正常,2级以上为声带麻痹)。喉镜评价声带运动采取类似标准。比较两种方法之间的差异,并以喉镜结果为金标准,绘制超声诊断声带麻痹的受试者工作特征曲线(receiver operating curve,ROC),计算曲线下面积(area under curve,AUC),计算敏感性、特异性、阳性预测值、阴性预测值、约登指数和诊断符合率。结果：35例患者中,喉镜与超声检查声带活动分级均为：1级5例,2级17例,3级13例。两者比较无统计学差异(X2 = 0.000,P = 1.000)。超声诊断声带麻痹的ROC曲线AUC为0.883(P = 0.007),敏感性96.67%,特异性80%,阳性预测值96.67%,阴性预测值80%,约登指数0.77,诊断符合率94.29。结论：超声评价声带活动对声带麻痹具有较高的诊断价值,可用于甲状腺癌侵犯喉返神经的术前评估。 |
| 关键词: 声带麻痹 甲状腺癌 超声检查 诊断 |
| DOI： |
| 投稿时间：2017-11-28修订日期：2017-12-20 |
| 基金项目: |
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| Evaluation of Vocal Cord Paralysis by UltrasonographyLi Shiwen 1, Hua Xing 2 (1Department of Ultrasound, Banan People’s Hospital; 2 Department of Ultrasound, the First Hospital Affiliated to Army Medical Unversity) |
| Li Shiwen,华兴 |
| () |
| Abstract: |
| Objective: to evaluate the value of ultrasonographic observation of vocal cord movement in the diagnosis of vocal cord paralysis. Methods: Thirty five cases of thyroid cancer accompanied by hoarseness confirmed by biopsy or surgery in our hospital were enrolled in this study. All the patients were examined ultrasonography and laryngoscope. The passive and active movements of vocal cord and arytenoid cartilage were observed by ultrasonography. The movements were categorized into grades 1~3 (grade 1 was regarded as normal while ≥ grade 2 as paralysis). The evaluation criterion for laryngoscope was similar. The difference between the two methods was statistically analyzed, and the receiver operating curve (ROC) for ultrasonogrpahy was drawn and area under curve (AUC), sensitivity, specificity, positive predictive value, negative positive value, Youden index and diagnose accordance rate were calculated. Results: Among 35 patients, the grading of vocal cord movements by ultrasonography and laryngoscope was the same: 5 cases in grade 1, 17 cases in grade 2 and 13 cases in grade 3, without significant difference between them (X2 = 0.000, P = 1.000). AUC of ROC for ultrasonographic diagnosis of vocal cord paralysis was 0.883 (P = 0.007). The sensitivity, specificity, positive predictive rate, negative predictive rate, Youden index and diagnose accordance rate were 96.67%, 80%, 96.67%, 80%, 0.77 and 94.29, respectively. Conclusion: Ultrasonography has a high value in the diagnosis of vocal cord paralysis and can be used to the presurgical evaluation of the invasion of thyroid cancer to the recurrent laryngeal nerve. |
| Key words: vocal cord paralysis thyroid cancer ultrasonography diagnosis |
