ACR TI-RADS分类联合超声造影在甲状腺良恶性结节鉴别中的应用价值

Application of ACR TI-RADS Combined with Contrast-enhanced Ultrasound for Diagnosis of Benign and Malignant Thyroid Nodules

【目的】探讨美国放射学会(ACR)甲状腺影像报告和数据系统(TI-RADS)分类联合超声造影(CEUS)在甲状腺良恶性结节鉴别中的应用价值。【方法】回顾性分析105例甲状腺结节患者(共153个结节)的超声影像学及CEUS资料,参照2017版ACR TI-RADS分类标准,对每个甲状腺结节赋分并分类,以手术病理检查结果为金标准,分析ACR TI-RADS分类联合CEUS在甲状腺良恶性结节中的鉴别诊断价值。【结果】病理结果显示:153个甲状腺结节恶性结节59个,良性结节94个。ACR TI-RADS分级联合CEUS诊断甲状腺癌的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为93.22%、95.74%、94.77%、93.22%、95.74%,均显著高于ACR TI-RADS分级的71.19%、84.04%、79.08%、73.68%、82.29%以及CEUS检查的79.66%、86.17%、83.66%、78.33%、87.1%,其差异均有统计学意义(P<0.05)。【结论】ACR TI-RADS分类联合CEUS在甲状腺良恶性结节中的具有较高的鉴别诊断价值,值得临床推广应用。

【Objective】To explore the diagnostic value of American College of Radiology(ACR)Thyroid Imaging Reporting and Data System(TI-RADS)classification combined with contrast-enhanced ultrasound(CEUS)for benign and malignant thyroid nodules.【Methods】The sonographic images and CEUS imaging data of 105 patients with thyroid nodules(153 nodules in total)were retrospectively analyzed.All thyroid nodules were classified into corresponding categories according to the criteria of ACR TI-RADS(version of year 2017).The diagnostic value of ACR TI-RADS classification combined with CEUS in benign and malignant thyroid nodules was evaluated based on the results of final surgical pathology examination.【Results】The pathological results showed that there were 94 benign nodules and 59 malignant nodules among total 153 thyroid nodules.The sensitivity,specificity,accuracy,positive and negative predictive value of ACR TI-RADS combined with CEUS for thyroid cancer diagnosis were 93.22%,95.74%,94.77%,93.22%,and 95.74%,respectively,which were significantly higher than those of either ACR TI-RADS alone(71.19%,84.04%,79.08%,73.68%and 82.29%,respectively,)or CEUS alone(79.66%,86.17%,83.66%,78.33%and 87.1%,respectively).The differences were statistically significant(all P<0.05).【Conclusion】The ACR TI-RADS classification combined with CEUS has a high diagnosis value for benign and malignant thyroid nodules.It is worthy of clinical application.