超声弹性应变率比值(SR)对甲状腺TI-RADS 4类结节的诊断价值

Diagnostic value of strain ratio(SR) for thyroid imaging reporting and data system 4 class thyroid nodules

目的探究弹性应变率比值(SR)在鉴别诊断甲状腺影像报告和数据系统(TI-RADS)4类结节中的应用价值。方法回顾性分析152例患者的154个甲状腺结节声像图特征,依据甲状腺影像报告和数据系统(TI-RADS)对相应的结节进行分类,其中TI-RADS 4a、4b和4c类分别为17个、31个和106个;所有结节均行弹性成像检查,并记录弹性应变率比值(SR),绘制受试者操作特征(ROC)曲线,获得弹性应变率比值(SR)鉴别诊断甲状腺良恶性结节的最佳界值。将入组的154个结节的SR值与病理结果进行对照研究。结果弹性应变率比值SR<0.50的甲状腺结节考虑为恶性,SR诊断恶性76个,良性78个;经术后病理证实,恶性78个,良性76个,SR诊断结果与实际结果差异相比较有统计学意义(P<0.05)。SR诊断TI-RADS 4类结节的准确性为88.31%,灵敏度为87.18%、特异度为89.47%、阳性预测值为89.47%、阴性预测值为87.18%。结论 SR能显著提高甲状腺结节诊断的准确性,对TI-RADS 4类结节有特殊的应用价值。

Objective To explore the differential diagnostic value of strain ratio（ SR） for thyroid imaging reporting and data system（ TI-RADS） 4 class thyroid nodules. Methods The ultrasound features of patients with 154 thyroid nodules from 152 patients were retrospectively analyzed. The malignant risk of each nodule was evaluated and classified according to TI-RADS. The classification of TI-RADS 4a,4b and 4c were respectively 17,31 and 106. All thyroid nodules were received ultrasonic elastography examination,and strain ratio（ SR） was recorded,the best cut-off point of SR was recorded by drawing receiver operating characteristic curve. The SR of 154 thyroid nodules were compared with the pathological results. Results In the study,the thyroid nodules of SR 0. 50 were recognized as malignant nodule. Among 154 TI-RADS 4 class thyroid nodules diagnosed by the strain ratio（ SR）,76 nodules were malignant and 78 nodules were benign. According to postoperative pathological results,78 nodules were malignant and 76 nodules were benign. The difference of strain ratio（ SR） diagnosis results and actual results was statistically significant（ P〈0. 01）. The accuracy,sensitivity,specificity,positive predictive value,and negative predictive value of SR diagnosis of TI-RADS 4 class thyroid nodules were 87. 18%,89. 47%,89. 47%,87. 18% and 88. 31%,respectively.Conclusion The SR examination is valuable for the diagnosis of 4 class thyroid nodules and can effectively improv the accuracy of preoperative diagnosis.