超声造影诊断TI-RADS 4级甲状腺结节临床价值

Clinical Value of Contrast-enhanced Ultrasonography in the Diagnosis of TI-RADS Grade 4 Thyroid Nodules

目的研究分析超声造影诊断TI-RADS4级恶性甲状腺微小结节临床价值。方法在2017年12月-2018年12月间,选择齐齐哈尔医学院附属第一医院有明确病理诊断的60例甲状腺结节患者(共85个结节),所有患者进行传统超声检查后行超声造影检查,采用TIRADS分级和CEUS评分进行联合诊断,比较诊断效果。结果85个甲状腺病理结节,超声造影诊断恶性结节60个(直径不足1cm13个),25个良性结节。常规超声TI-RADS分级(3级及以下20个,4级34个,5级及以上31个),甲状腺结节良恶性与手术病理类型比较,差异无统计学意义(χ^2=1.206,P>0.05)。60个甲状腺乳头状癌的常规TI-RADS分级、CEUS评分,TI-RADS分级诊断准确率达到53.19%(25/47),CEUS评分分级诊断甲状腺恶性结节的准确率68.08%(32/47),两组比较具有显著性差异(χ^2=8.026,P<0.05);直径不足1cm的微小肿瘤,TI-RADS分级诊断准确率达到76.92%(10/13),CEUS评分分级诊断的准确率为84.62%(11/13),两组比较不具有统计学意义(χ^2=2.065,P>0.05)。结论超声造影对甲状腺TI-RADS4级结节具有校正及提高鉴别诊断的价值。

Objective To study the clinical value of contrast-enhanced ultrasonography in the diagnosis of TI-RADS grade 4 malignant thyroid micronodules. Methods From December 2017 to December 2018, 60 patients with thyroid nodules (85 nodules) with clear pathological diagnosis were selected from the First Affiliated Hospital of Qiqihar Medical College. All patients underwent traditional ultrasound examination and ultrasound contrast imaging. Examination, combined diagnosis with TI-RADS classification and CEUS score, the diagnostic results was compared. Results 85 thyroid pathological nodules were diagnosed by contrast-enhanced ultrasonography in the diagnosis of 60 malignant nodules (less than 1 cm in diameter was 13 cases) and 25 benign nodules. Conventional ultrasound TIRADS classification (20 grades 3 and below, grade 4 was 34, grade 5 and above 31), thyroid nodules compared with surgical pathology, the difference was not statistically significant (χ^ 2=1.206, P > 0.05). The conventional TIRADS classification and CEUS score of 60 thyroid papillary carcinomas, the accuracy of TI-RADS classification diagnosis reached 53.19%(25/47), and the accuracy of CEUS score diagnosis of thyroid malignant nodules was 68.08%(32/47). There was a significant difference between the two groups (χ^ 2=8.026, P < 0.05);for small tumors less than 1cm in diameter, the accuracy of TI-RADS classification diagnosis reached 76.92%(10/13), and the accuracy of CEUS score classification diagnosis was 84.62%(11/13), the two groups were not statistically significant(χ^2=2.065, P > 0.05). Conclusion Contrast-enhanced ultrasonography has the potential to correct and improve differential diagnosis of thyroid TI-RADS grade 4 nodules.