甲状腺影像报告与数据系统联合超声弹性成像对甲状腺良恶性结节的诊断价值

发布时间：2018-06-12 14:11

本文选题：甲状腺结节 + 甲状腺肿瘤　；参考：《中国医学影像学杂志》2015年05期

【摘要】：目的评价甲状腺影像报告与数据系统(TI-RADS)联合超声弹性成像技术在甲状腺良恶性结节鉴别诊断中的价值。资料与方法回顾性分析手术或穿刺活检病理证实的174例甲状腺结节(232个病灶)患者的临床资料,所有结节分别行灰阶超声及弹性成像检查。计算TI-RADS、超声弹性成像及联合诊断甲状腺良恶性结节的敏感度、特异度、准确度、阳性预测值及阴性预测值。绘制TI-RADS、超声弹性成像及联合诊断甲状腺良恶性结节的受试者工作特征(ROC)曲线,比较ROC曲线下面积。结果超声弹性成像诊断良性结节155个,恶性结节77个,诊断敏感度、特异度及准确度分别为88.9%、91.8%、90.9%;TI-RADS分类诊断良性结节153个,恶性结节79个,诊断敏感度、特异度及准确度分别为76.4%、85.0%、82.3%,弹性成像的敏感度及准确度均高于TI-RADS,差异有统计学意义(χ2=3.920、7.446,P0.05);联合诊断诊断良性结节155个,恶性结节77个,敏感度、特异度及准确度分别为93.0%、93.7%、93.5%,均高于单一检查方法(χ2=7.725、6.450、13.728,P0.05)。弹性成像、TI-RADS及联合诊断的ROC曲线下面积分别为0.833、0.812、0.914,联合诊断准确率高于单一方法,差异有统计学意义(Z=1.95、2.55,P0.05)。结论与单纯灰阶超声相比,TI-RADS与弹性成像联合应用能够提高甲状腺良恶性结节的诊断敏感度及准确度。
[Abstract]:Objective to evaluate the value of TI-RADS combined with TI-RADS in differential diagnosis of benign and malignant thyroid nodules. Materials and methods Clinical data of 174 patients with thyroid nodules (232 lesions) confirmed by operation or biopsy were analyzed retrospectively. All the nodules were examined by gray scale ultrasonography and elastic imaging respectively. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of TI-RADS, ultrasound elastography and combined diagnosis of benign and malignant thyroid nodules were calculated. The operating characteristics of TI-RADS, elastography and combined diagnosis of benign and malignant thyroid nodules were drawn and the area under the ROC curve was compared. Results the diagnostic sensitivity, specificity and accuracy of elastography in the diagnosis of 155 benign nodules and 77 malignant nodules were 88.9 and 91.8%, respectively. TI-RADS was used to classify 153 benign nodules and 79 malignant nodules. The sensitivity and accuracy of elastic imaging were significantly higher than those of TI-RADSs (蠂 2 / 3.9207.446 P 0.05), and the sensitivity and accuracy of elastic imaging were significantly higher than those of TI-RADSs (蠂 2 / 3.9207.446 P 0.05A, P < 0.05), and combined diagnosis of benign nodules (155 cases), malignant nodules (77 cases), and sensitivity (P < 0.05), the accuracy of elastic imaging was higher than that of TI-RADSs. The specificity and accuracy were 93.0 and 93.7, respectively, which were higher than that of single examination (蠂 ~ 2 7.725 ~ 6.450 ~ 13.728 P 0.05). The area under the ROC curve of TI-RADS and combined diagnosis was 0.833 ~ 0.812 ~ 0.914, respectively. The accuracy of combined diagnosis was higher than that of a single method, and the difference was statistically significant. Conclusion the combination of TI-RADS and elastic imaging can improve the diagnostic sensitivity and accuracy of benign and malignant thyroid nodules.
【作者单位】：青岛大学附属医院心脏超声科;烟台毓璜顶医院超声科;
【分类号】：R736.1;R445.1

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