CEUS定性分析诊断不同大小甲状腺良恶性结节

Qualitative analysis of CEUS in benign and malignant thyroid nodules with different sizes

目的探讨CEUS定性诊断不同大小甲状腺良恶性结节的价值。方法根据甲状腺结节的最大径,将255例甲状腺结节患者的329个结节分为小结节组(最长径≤1cm,n=166)和大结节组(最长径>1cm,n=163)。采用χ2检验分别比较2组甲状腺良恶性结节CEUS特征的差异,并对CEUS特征进行赋值评分,绘制ROC曲线评价CEUS特征评分对不同大小良恶性甲状腺结节的鉴别诊断效能。结果小结节组甲状腺良恶性结节增强程度、增强方式、增强达峰时结节边界、增强达峰时结节形态及增强均匀性差异均有统计学意义(P均<0.05);大结节组甲状腺良恶性结节增强程度、增强方式、增强达峰时结节边界、形态、增强达峰时结节增强均匀性、增强达峰时结节是否完全充填、增强后结节大小差异均有统计学意义(P均<0.05)。ROC曲线结果显示,小结节组CEUS评分鉴别甲状腺良恶性结节的临界值为3.5分,AUC为0.889(P<0.001),敏感度、特异度、准确率分别为77.90%、84.06%和78.66%;大结节组CEUS评分鉴别甲状腺良恶性结节的临界值为2.5分,AUC为0.910(P<0.001),敏感度、特异度、准确率分别为90.40%、76.60%和81.13%。结论 CEUS定性分析对鉴别诊断不同大小甲状腺良恶性结节均有较高价值。

Objective To explore the value of qualitative analysis of CEUS in diagnosis of benign and malignant thyroid nodules(TNs)with different sizes.Methods Totally 329 TNs in 255 patients were divided into small size group(≤1 cm,n=166)and large size group(>1 cm,n=163).CEUS characteristics were compared with Chi-square test between benign and malignant TNs in the two groups.CEUS characteristics were assigned scores,and ROC curve was performed to evaluate the diagnostic efficacy of these scores in diagnosis of benign and malignant TNs with different sizes.Results In the small size group,there were significant differences in the degree,patterns of enhancement,boundary,shape and homogeneity of enhancement between benign and malignant TNs(all P<0.05).In the large size group,there were significant differences in the degree,patterns of enhancement,boundary,shape,homogeneity of enhancement,completeness of enhancement,size of the enhanced lesions between benign and malignant TNs(all P<0.05).In small size group,taking 3.5 points as the cut off value,AUC of ROC curve was 0.889(P<0.001),and the sensitivity,specificity,accuracy was 77.90%,84.06%and 78.66%,respectively.In the large size group,taking 2.5 points as the cut off value,AUC was 0.910(P<0.001),and the sensitivity,specificity,accuracy was 90.40%,76.60%and 81.13%,respectively.Conclusion Qualitative analysis of CEUS has high value in differential diagnosis of benign and malignant TNs with different sizes.