TI-RADS分级结合剪切波弹性成像及超微血管成像在鉴别甲状腺良恶性结节中的诊断价值

Value of thyroid imaging-reporting and data system combined with shear wave elastography and superb microvascular imaging in the differentiation of benign and malignant thyroid nodules

目的研究甲状腺影像报告与数据系统(thyroid imaging reporting and data system,TI-RADS)结合超声剪切波弹性成像(shear wave elastography,SWE)及超微血管成像技术(superb microvascular imaging,SMI)在甲状腺良恶性结节鉴别诊断中的价值。方法回顾性分析118例甲状腺结节患者共163个病灶的声像图资料,所有患者均分别行二维灰阶超声、SWE及SMI成像技术检查,进行量化评分,以联合评分法重新调整TI-RADS分级。病理结果经手术或穿刺活检,绘制ROC曲线,比较曲线下面积(AUC)。结果 163个甲状腺结节中良性结节105个,恶性结节58个,联合前的TI-RADS分级诊断敏感度、特异度分别为89.52%、93.41%,曲线下面积AUC为0.933;联合后的TI-RADS分级诊断敏感度、特异度分别为94.80%、94.32%,曲线下面积AUC为0.957,差异有统计学意义(P<0.05)。结论 TIRADS分级结合剪切波弹性成像及SMI技术能够显著提高甲状腺良恶性结节诊断的准确性。

Objective To investigate the value of combined application of thyroid imaging reporting and data system （TI-RADS）, the shear wave elastography （SWE） and the superb mierovascular imaging （SMI） in differentiating benign and malignant thyroid nodules. Methods A retrospective analysis of 118 patients including 163 thyroid nodules with ultrasonographic imaging data was carried out. All the nodules underwent SWE and SMI, the quantitative score was getten by the TI-RADS system and the results were eomfirmed by the pathology exam. According to the readjusted TI-RADS system and pathologic results, the ROC was drawn to evalute the value of diagnosis of benign and malignant thyroid nodules by the area under curve （AUC）. Results There were 163 pathologically proven thyroid nodules including 105 benign and 58 malignant lesions. The diagnostic sensitivity, specificity of uncombined TI-RADS were 89.52% and 93.41% TI-RADS were 94.80% significant （ P 〈 0. 05 ）. the AUC was 0. 933 ; the diagnostic sensitivity, specificity of combined and 94.32% , the AUC was 0.957, and the difference was statistically Conclusion TI-RADS combined with SWE and SMI can significantly improve the accuracy of the diagnosis of thyroid benign and malignant nodules.