UE技术联合CDFI检查对甲状腺TI-RADS 4级病变良恶性鉴别诊断效能的影响

Effect of UE technique combined with CDFI examination on differential diagnosis of benign and malignant thyroid TI-RADS grade 4 lesions

目的 研究超声弹性成像(UE)技术联合彩色多普勒血流显像(CDFI)检查对甲状腺超声影像报告和数据系统(TI-RADS)4级病变良恶性鉴别诊断效能的影响。方法 选取本院2016年11月至2018年8月收诊的甲状腺TI-RADS 4级病变患者134例,其中良性病变者64例,恶性病变者70例,均行UE技术、CDFI检查,比较良、恶性病变患者UE评分、CDFI血流特征,以病理结果为金标准,比较UE技术联合CDFI检查及单独检查诊断效能。结果 (1)CDFI血流特征:经Ridit检验可知,恶性病变者CDFI血流特征与良性病变者相比,差异有统计学意义(P<0.05);(2)UE评分:恶性病变者UE评分高于良性病变者,差异有统计学意义(P<0.05);(3)诊断结果:CDFI检查出恶性57例,良性77例,其中误诊13例,漏诊26例;UE技术检查出恶性66例,良性68例,其中误诊12例,漏诊16例;两者联合检查出恶性80例,良性54例,其中误诊13例,漏诊3例。(4)诊断价值:UE技术联合CDFI检查甲状腺TI-RADS 4级病变者诊断准确度88.06%、敏感度95.71%高于两者单独检查[(79.10%、70.90%)、(77.14%、62.86%)],差异有统计学意义(P<0.05);两者联合检查诊断特异度(79.69%)与单独检查(81.25%、79.69%)比较差异无统计学意义(P >0.05)。结论 UE技术联合CDFI检查应用于甲状腺TI-RADS 4级病变患者诊断中,可在不影响诊断特异度基础上显著提高诊断准确度、敏感度,为临床准确鉴别良恶性、判断病情、制定治疗方案提供重要指导信息。

Objective To investigate the effect of ultrasound elastography(UE)combined with color Doppler flow imaging(CDFI)on the differential diagnosis of benign and malignant thyroid ultrasound imaging report and data system(TI-RADS)grade 4 lesions.Methods A total of 134 patients with thyroid TI-RADS grade 4 lesions from November 2016 to August 2018 were enrolled,including 64 patients with benign lesions and 70 patients with malignant lesions.All patients underwent UE technique and CDFI examination.The scores of UE and the characteristics of CDFI blood flow of patients with benign and malignant lesions were compared.With the pathological results as the golden standard,the values of UE technique combined with CDFI and separate examination were compared.Results(1)CDFI blood flow characteristics:Ridit test showed that the CDFI blood flow characteristics of patients with malignant lesions were significantly different from those of benign lesions(P<0.05).(2)UE score:UE score of patients with malignant lesions was higher than that of patients with benign lesions,with statistically significant difference(P<0.05).(3)Diagnostic results:57 malignant cases and 77 benign cases were detected by CDFI,including 13 cases of misdiagnosis and 26 cases of missed diagnosis;66 malignant cases and 68 benign cases were detected by UE technique,including 12 cases of misdiagnosis and 16 cases of missed diagnosis;80 malignant cases and 54 benign cases were detected by the combined examination,including 13 cases of misdiagnosis and 3 cases of missed diagnosis.(4)Diagnostic value:UE technology combined with CDFI examination for thyroid TI-RADS grade 4 lesions with a diagnostic accuracy of 88.06%and a sensitivity of 95.71%,higher than those of the two separate examinations[(79.10%,70.90%),(77.14%,62.86%)](P<0.05);there was no statistically significant difference in the diagnostic specificity between the combined examination and the two separate examinations(79.69%,81.25%,79.69%)(P >0.05).Conclusions The combination of UE technology and CDFI in the diagnosis of thyroid TI-RADS grade 4 lesions can significantly improve the diagnostic accuracy and sensitivity without affecting the diagnostic specificity,which can accurately identify benign and malignant lesions,judge the condition,formulate treatment plan,and provide important guidance information.