目的 探讨超声实时剪切波弹性成像联合美国放射学会(ACR)颁布的甲状腺影像报告和数据系统(TI-RADS)分类诊断良恶性甲状腺结节的价值。方法 选择2016-12至2018-12医院收治的甲状腺结节患者277例,均于超声科进行剪切波弹性成像检查获得杨氏模量值,并对超声图像进行TI-RADS分级。根据病理结果将患者分为良性组和恶性组,对比良恶性甲状腺结节杨氏模量值、TI-RADS分级差异,分析杨氏模量值、TI-RADS分级、联合诊断对鉴别良恶性甲状腺结节的价值。结果 本组恶性甲状腺结节75例,良性甲状腺结节202例。良性组甲状腺结节弹性评分、SR值均低于恶性组(P＜0.05),根据ACR TI-RADS分类标准诊断恶性甲状腺结节正确率为88.09%(244/277)。ROC分析结果示联合ACR TI-RADS分类、UE诊断甲状腺癌的效能最高,其曲线下面积(AUC)为0.922(95%CI:0.853~0.991,P=0.000),灵敏度、特异度分别为97.33%、99.50%。结论 UE联合ACR TI-RADS分类可提高对良恶性甲状腺结节的诊断正确率。
Abstract
Objective To explore the applicability of ultrasound real-time shear wave elastography combined with the American Radiological Society (ACR) thyroid imaging report and data system (TI-RADS) in the diagnosis of benign and malignant thyroid nodules.Methods A total of 277 patients with thyroid nodules admitted to our hospital between December 20, 2016 and December 5, 2018 were selected. All the patients underwent shear wave elastography in the Department of Ultrasound to obtain Young's modulus values and ultrasound images. TI-RADS classification was conducted. According to the biopsy or pathological results, the patients were divided into the benign group and malignant group. The Young’s modulus values and TI-RADS classification difference between benign and malignant thyroid nodules were compared. The Young’s modulus values, TI-RADS classification and joint diagnosis were analyzed. The values of benign and malignant thyroid nodules were determined.Results There were 75 cases of malignant thyroid nodules and 202 cases of benign ones. The elasticity score and SR value of thyroid nodules in the benign group were lower than those in the malignant group (P＜0.05). The correct rate of diagnosis of malignant thyroid nodules according to ACR TI-RADS classification criteria was 88.09% (244/277). ROC analysis showed that the combination of ACR TI-RADS classification and UE had the highest diagnostic efficiency for thyroid cancer. The area under curve (AUC) was 0.922 (95% CI: 0.853-0.991, P=0.000), and the sensitivity and specificity were 97.33% and 99.50% respectively.Conclusions UE combined with ACR TI-RADS classification can improve the diagnostic accuracy of benign and malignant thyroid nodules.
关键词
超声实时组织弹性成像 /
ACR TI-RADS分类 /
甲状腺结节 /
诊断
Key words
ultrasound real-time tissue elastography /
ACR TI-RADS classification /
thyroid nodules /
diagnosis
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