超声弹性成像对甲状腺结节TI-RADS分类的影响研究

Research on Effect of Ultrasonic Elastography on TI-RADS Classification of Thyroid Nodules

目的探究超声弹性成像对甲状腺结节TI-RADS分类的影响。方法由两名超声科主治医师分别独立对2014年1月—2015年5月之间来该院接受超声检查的174例患者,共254个结节进行常规及弹性超声检测,对比常规超声TI-RADS分类和超声弹性成像TI-RADS分类对恶性风险的评估价值。结果医师A常规超声TI-RADS分类的准确性及特异性分别为75.6%和71.8%,医师B则分别为77.9%和74.4%,两个医师的诊断具有一致性(Kappa=0.569);医师A弹性成像TI-RADS分类的准确性及特异性分别为86.6%和87.2%,医师B则分别为88.2%和88.5%,两个医师的诊断具有一致性(Kappa=0.682);两个医师组内检测的弹性超声及常规超声的准确性、特异性差异有统计学意义(χ2=5.24,4.85,5.05,5.15;均P<0.05)。结论超声弹性成像能够提高TI-RADS分类的准确性及特异性,对于甲状腺结节恶性风险的评估价值更高。

Objective To study the effect of ultrasonic elastography on TI-RADS classification of thyroid nodules. Methods254 nodules from 174 cases of patients receiving ultrasonic examination in our hospital from January 2014 to May 2015 were given conventional and elastic ultrasonic testing by two physicians in the department of ultrasound independently, and the evaluation values of conventional ultrasonic TI-RADS classification and ultrasonic elastography TI-RADS classification for the malignant risks were compared. Results The accuracy and specificity of conventional ultrasonic TI-RADS classification were respectively 75.6% and 71.8% by the physician A and 77.9% and 74.4% by the physician B, and the diagnoses of the two physicians were consistent（Kappa=0.569）, the accuracy and specificity of the ultrasonic elastography TI-RADS classification were respectively 86.6% and 87.2% by the physician A and 88.2% and 88.5% by the physician B, and the diagnoses of the two physicians were consistent（Kappa=0.682）, and there were obvious differences in the accuracy and specificity of the elastic ultrasound and conventional ultrasound between the two physicians（χ2=5.24, 4.85, 5.05, 5.15; all P〈0.05）. Conclusion Ultrasonic elastography can improve the accuracy and specificity of TI-RADS classification, and the evaluation value for malignant risk of thyroid nodules is higher.