改良ACR TI-RADS超声词典鉴别甲状腺滤泡性肿瘤良恶性的临床研究

The value of modified lexicon of ACR TI-RADS in diagnosis of benign and malignant thyroid follicular neoplasms

目的探讨改良ACR TI-RADS超声词典在甲状腺滤泡性肿瘤良恶性的鉴别诊断中的价值。方法选择术后经病理证实为甲状腺滤泡性肿瘤的121例连续性病例进行回顾性分析,其中甲状腺滤泡癌50例,甲状腺滤泡性腺瘤71例。收集并分析所有病变基于改良ACR TI-RADS超声诊断词典的病变特征。结果甲状腺滤泡癌与滤泡性腺瘤在边缘、晕环、内部血流分级、血管模式的比较差异有统计学意义(P<0.05)。边缘呈分叶状及不规则、中央血流为主预测甲状腺滤泡癌的敏感性和特异性分别为:26.00%和98.59%、80.00%和56.34%。结论改良ACR TI-RADS超声诊断词典中病变分叶状及不规则边缘、不规则晕、内部血流3级、中央血流为主的血管分布模式对甲状腺滤泡癌的诊断具有重要的临床价值。

Objective To explore the value of modified lexicon of ACR TI-RADS in diagnosis of benign and malignant neoplasms of thyroid follicular.Methods 121 consecutive cases of thyroid follicular neoplasms confirmed by post-operation pathological analysis were retrospectively analyzed.There were 50 cases of thyroid follicular carcinoma and 71 cases of thyroid follicular adenoma.Characteristics of cases collected were analyzed according to the modified lexicon of ACR TI-RADS.Results There was statistical significance of different features of in the margin,halo,internal flow grading,vascular pattern between thyroid follicular carcinoma and thyroid follicular adenoma(P<0.05).The sensitivity and specificity of diagnosing thyroid follicular carcinoma through preference central hypervascularity and spiculated/microlobulated boundary were respectively 26.00% and 98.59%,80.00% and 56.34%.Conclusion Modification of distribution patterns of spiculated and microlobulated margin,irregular halo ring,grade 3 internal flow,and central hypervascularity in lexicon of ACR TI-RADS has important clinical value in the diagnosis of thyroid follicular carcinoma.