超声造影对甲状腺影像报告和数据系统4类结节良恶性的诊断价值

Diagnostic value of contrast-enhanced ultrasound in the differential diagnosis of thyroid imaging reporting and data system 4 nodules

目的应用超声造影评估甲状腺影像报告和数据系统(TI-RADS)4类结节的恶性风险,探讨其对TI-RADS4类结节良恶性的诊断价值。方法选取我院经常规超声诊断的TI-RADS4类结节患者219例,共226个结节,所有结节均行超声造影检查,分析超声造影对其诊断效能。结果226个TI-RADS4类结节病理诊断恶性110个,良性116个;超声造影准确诊断恶性98个,良性105个;超声造影对TI-RADS4类结节的诊断准确率、敏感性、特异性、阳性预测值及阴性预测值分别为89.23%、89.09%、90.52%、89.91%及89.74%。超声造影诊断TI-RADS4A、4B、4C类结节的实际恶性率分别为14.06%(9/64)、47.52%(48/101)及86.89%(53/61)。结论超声造影检查对TI-RADS4类结节具有较高的诊断价值,有助于指导临床选择正确的治疗方案。

Objective To explore the malignant risk and clinical diagnostic value of contrast-enhanced ultrasonography(C EUS)for thyroid imaging reporting and data system(TI-RADS)4 nodules.Methods Totally 219 cases(226 nodules)of TI-RADS 4 nodules diagnosed by routine ultrasound in our hospital were selected.All nodules were examined by contrast-enhanced ultrasound at the same time,and the diagnostic efficacy of contrast-enhanced ultrasound was analyzed.Results There were 226 TI-RADS 4 nodules with pathological diagnosis of 110 malignant and 116 benign,98 malignant and 105 benign were diagnosed accurately by contrast-enhanced ultrasound.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of CEUS in the diagnosis of TI-RADS 4 nodules were 89.23%,89.09%,90.52%,89.91%and 89.74%,respectively.The actual rates of malignancy of CEUS in the diagnosis of TI-RADS 4A,4B and 4C nodules were 14.06%(9/64),47.52%(48/101)and 86.89%(53/61),respectively.Conclusion CEUS has high diagnostic value for TI-RADS 4 nodules.It is helpful to guide the clinical follow-up decision-making of TI-RADS 4 nodules.