剪切波弹性成像技术改良传统TI-RADS诊断标准的研究

发布时间：2018-04-18 20:48

本文选题：弹性成像 + 甲状腺　；参考：《重庆医学》2016年31期

【摘要】：目的探讨应用剪切波(SWE)划分TI-RADS 4级的2个亚级,能否改善传统TI-RADS诊断标准的一致性及准确性。方法将240例甲状腺单发实性结节根据TI-RADS诊断标准分为3、4、5级。选取151例TI-RADS 4级者行SWE检查,获取结节杨氏模量平均值,通过与最佳界点比较,将上述4级结节划分为2个亚级,分析其诊断效能及观察者内、观察者间的一致性。另外,两名医师以传统TI-RADS诊断标准划分2个亚级,分析其观察者内、观察者间的一致性及诊断效能。结果 SWE标准观察者内重复性及两名医师间的一致性均较好(k0.8);而传统TI-RADS诊断标准除高年资医师重复性较好外(k0.8),其一致性均较差(k0.8)。SWE标准ROC曲线下面积(AUC)与使用常规TI-RADS诊断标准的高年资医师差异无统计学意义(P=0.734,0.465),而优于同样使用传统TI-RADS标准的低年资医师(P=0.020,0.034)。结论 SWE可作为4级结节2个亚级的判定标准,在不降低准确性的同时可提高其诊断一致性。
[Abstract]:Objective to explore whether the application of shear wave wave (SWE) can improve the consistency and accuracy of traditional diagnostic criteria for TI-RADS 4 by dividing them into two subgrades.Methods 240 cases of thyroid solitary solid nodules were divided into 3 groups according to TI-RADS diagnostic criteria.The average value of Young's modulus of nodules was obtained by SWE in 151cases of TI-RADS grade 4. The nodules were divided into two subgrades by comparison with the optimal boundary points. The diagnostic efficacy and the consistency among observers were analyzed.In addition, two physicians were divided into two subclasses according to traditional TI-RADS diagnostic criteria, and the consistency and diagnostic efficacy among observers were analyzed.Results Intra-observer reproducibility of SWE standard and consistency between two physicians were better than that between two physicians, but the traditional diagnostic criteria for TI-RADS, except for senior medical practitioners, were less consistent than those in the standard ROC curve (area under the ROC curve) and routine use.There was no significant difference in TI-RADS diagnostic criteria between senior and senior doctors, but the difference was better than that of younger doctors who also used traditional TI-RADS criteria (0.020% 0.034%).Conclusion SWE can be used as two subgrade criteria for 4 grade nodules, and it can improve the diagnostic consistency without reducing the accuracy.
【作者单位】：河南科技大学第三附属医院/洛阳东方医院超声科;
【分类号】：R581;R445.1

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