声触诊组织量化成像技术鉴别诊断甲状腺影像报告和数据系统4类甲状腺结节

Virtual touch tissue quantification imaging in differential diagnosis of thyroid imaging report and data system 4 thyroid nodules

目的探讨声触诊组织量化(VTQ)成像技术对甲状腺影像报告和数据系统(TI-RADs)4类结节的良恶性鉴别诊断价值。方法对88个常规超声评价为TI-RADs 4类的甲状腺结节行VTQ检查。比较VTQ与TI-RADs分类的诊断效能。结果 88个TI-RADs 4类甲状腺结节中,良性结节56个,恶性结节32个。以TI-RADs 4b类和4c类诊断为恶性结节,其诊断敏感度、特异度、阳性预测值、阴性预测值及准确率分别为90.63%(29/32)、57.14%(32/56)、54.72%(29/53)、91.43%(32/35)及69.32%(61/88)。甲状腺恶性结节VTQ值[(3.26±0.94)m/s]明显高于良性结节VTQ值[(2.03±0.61)m/s,t=7.082,P<0.001]。VTQ的最佳诊断界值为2.795m/s,其诊断甲状腺结节良恶性的敏感度、特异度、阳性预测值、阴性预测值及准确率分别为78.13%(25/32)、91.07%(51/56)、83.33%(25/30)、87.93%(51/58)及86.36%(76/88)。VTQ值诊断TI-RADs 4类甲状腺结节良恶性的特异度及阳性预测值明显高于TI-RADs分类(P均<0.05)。结论 VTQ技术有助于TI-RADs 4类甲状腺结节的良恶性鉴别诊断,值得临床推广。

Objective To explore the value of virtual touch tissue quantification(VTQ)imaging in differential diagnosis of thyroid imaging report and data system(TI-RADs)4 thyroid nodules.Methods Eighty-eight thyroid nodules identified as TI-RADs 4 using conventional ultrasound underwent VTQ examinations.The diagnostic efficiencies of VTQ value and TI-RADs were compared.Results Among 88 TI-RADs 4 thyroid nodules,there were 56 benign and 32 malignant nodules.Taken TI-RADs 4b and 4c as malignant,the diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy was 90.63%(29/32),57.14%(32/56),54.72%(29/53),91.43%(32/35)and 69.32%(61/88),respectively.VTQ values of malignant nodules were significantly higher than that of benign nodules([3.26±0.94]m/s vs[2.03±0.61]m/s,t=7.082,P<0.001).Taken VTQ=2.795 m/s as the cut-off point,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy in differential diagnosis of malignant and benign thyroid nodules was 78.13%(25/32),91.07%(51/56),83.33%(25/30),87.93%(51/58)and 86.36%(76/88),respectively.The specificity and positive predictive value of VTQ value were significantly higher than those of TI-RADs(both P<0.05).Conclusion VTQ was helpful to differential diagnosis of TI-RADs 4 thyroid nodules and worthy of clinical application.