TI-RADS分级联合剪切波弹性成像对甲状腺微小癌的诊断价值

发布时间：2018-03-24 18:42

本文选题：超声检查　切入点：剪切波弹性成像　出处：《临床耳鼻咽喉头颈外科杂志》2016年02期

【摘要】：目的:探讨超声甲状腺影像报告与数据系统(TI-RADS)、超声剪切波弹性成像及两者联合应用对甲状腺微小癌(TMC)的诊断价值。方法:回顾性分析经手术病理证实的323个甲状腺微小结节的超声TI-RADS和实时剪切波弹性成像特征。并以手术病理作为金标准,绘制ROC曲线得出SWE诊断甲状腺微小结节良恶性的各参数最佳阈值。统计分析超声TI-RADS分级、SWE及SWE联合TI-RADS对TMC诊断的敏感性、特异性、准确性、阳性预测值、阴性预测值并绘制ROC曲线,计算AUC。进一步得出SWE联合TI-RADS对不同大小的甲状腺微小结节临床诊断价值。结果:323个结节中253个恶性结节,70个良性结节。SWE技术各参数SWE_max、SWE_mean和SWE_min的AUC分别为0.648、0.629和0.605。当SWE_max=66.50kpa,SWE_mean=37.50kpa时,TI-RADS和SWE诊断TMC的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为88.14%、82.86%、87.00%、94.89%、65.91%和49.01%、74.29%、54.49%、87.32%、28.73%,2种诊断方法在敏感性、准确性、阳性预测值上差异有统计学意义,在特异性和阴性预测值上差异无统计学意义。SWE联合TIRADS诊断TMC的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为95.26%、67.14%、89.16%、91.29%、79.66%。超声TI-RADS分级、SWE及SWE联合TI-RADS应用对甲状腺微小结节诊断的AUC分别为0.763、0.616、0.804。SWE联合TI-RADS应用诊断5mm以下及5~10mm甲状腺结节的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为91.67%、66.67%、87.07%、92.44%、64.29%和98.50%、67.44%、90.91%、90.34%、93.55%。结论:超声TI-RADS与SWE两者联合可进一步提高TMC的临床诊断水平。
[Abstract]:Objective: to investigate the diagnostic value of TI-RADSN, Shear wave elastography and their combination in thyroid microcarcinoma TMC.Methods: 323 thyroid thyroid carcinoma confirmed by operation and pathology were analyzed retrospectively. Ultrasound TI-RADS and real time shear wave elastography features of small nodules of the gland. ROC curve was drawn to obtain the best threshold value of SWE for the diagnosis of benign and malignant thyroid micronodules. The sensitivity, specificity, accuracy and positive predictive value of TI-RADS classification and SWE combined with TI-RADS in the diagnosis of TMC were statistically analyzed. Negative predictors and ROC curves, Further, the clinical diagnostic value of SWE combined with TI-RADS for thyroid micronodules of different sizes was obtained. Results of 253 malignant nodules, 70 benign nodules, 70 benign nodules, the AUC of SWE and SWE_min were 0.6480.69 and 0.605, respectively. When SWEmax.50kpaSWE, the mean value of SWE37.50kpa was 37.50kpa. Sensitivity of TI-RADS and SWE in the diagnosis of TMC. The specificity, accuracy, positive predictive value and negative predictive value were 88.14, 82.86 and 87.00, respectively. There were significant differences in sensitivity, accuracy and positive predictive value between the two diagnostic methods. There was no significant difference between specificity and negative predictive value. The sensitivity, specificity and accuracy of TIRADS combined with SWE in the diagnosis of TMC were not statistically significant. The positive predictive value and negative predictive value were 95.26 and 67.14 and 89.160.The sensitivity, specificity and accuracy of TI-RADS and SWE combined with TI-RADS in the diagnosis of thyroid micronodule were 0.763n0.6160.804.SWE and 5~10mm, respectively, and the sensitivity, specificity and accuracy of SWE combined with TI-RADS in the diagnosis of thyroid nodules below 5mm and 5~10mm were 79.663.The sensitivity, specificity and accuracy of SWE and SWE in the diagnosis of thyroid nodules below 5mm and 5~10mm were 0.76 3 卤0. 616 and 0. 804.SWE, respectively. The positive predictive value and the negative predictive value were 91.67 and 66.67 and 92.444.29% and 98.50%, respectively. Conclusion: the combination of ultrasound TI-RADS and SWE can further improve the clinical diagnosis of TMC.
【作者单位】：哈尔滨医科大学肿瘤医院超声科;
【分类号】：R736.1;R445.1

【相似文献】