超声造影联合甲状腺影像报告和数据系统分类对甲状腺良恶性结节的鉴别诊断价值

Application value of contrast-enhanced ultrasound combined with thyroid imaging reporting and data system classification in the differential diagnosis of benign and malignant thyroid nodules

目的:探讨超声造影(CEUS)联合甲状腺影像报告和数据系统(TI-RADS)分类鉴别诊断甲状腺良恶性结节的价值。方法:选取山西医科大学第一医院2016年1月至2017年1月行常规超声及CEUS检查的患者122例共157个甲状腺结节的检查资料,分析图像特征进行常规超声TI-RADS分类,根据CEUS增强模式,将造影后结节重新进行TI-RADS分类;以病理结果为标准,比较CEUS后TI-RADS分类与单纯常规超声TI-RADS分类的诊断效能。结果:甲状腺结节CEUS后TI-RADS分类曲线下面积(AUC=0.900)大于单纯常规超声TI-RADS分类(AUC=0.808)。单纯常规超声TI-RADS分类诊断恶性结节的敏感度、特异度、准确度、阳性及阴性预测值分别为81.6%(80/98)、67.8%(40/59)、76.4%(120/157)、80.8%(80/99)、68.9%(40/58),CEUS后TI-RADS分类诊断分别为98.0%(96/98)、78.0%(34/59)、90.4%(142/157)、88.1%(96/109)、95.8%(46/48),CEUS后TI-RADS分类鉴别甲状腺结节良恶性的敏感性明显高于单纯常规超声TI-RADS分类,差异有统计学意义(χ^(2)=12.50,P<0.001)。结论:CEUS联合TI-RADS分类对甲状腺结节良恶性的鉴别诊断效能比单一常规超声TI-RADS分类高。

Objective To investigate the application value of contrast-enhanced ultrasound(CEUS)combined with thyroid imaging reporting and data system(TI-RADS)classification in the differential diagnosis of benign and malignant thyroid nodules.Methods The clinical data of 157 thyroid nodules from 122 participants who underwent conventional ultrasound and CEUS examination from January 2016 to January 2017 in the First Hospital of Shanxi Medical University,China were collected.The image features were analyzed for conventional ultrasound and TI-RADS classification.According to CEUS results,the thyroid nodules were classified by TI-RADS.Based on pathological results,the efficacy of CEUS combined with TI-RADS classification versus conventional ultrasound combined with TI-RADS classification in the differential diagnosis of benign and malignant thyroid nodules was investigated.Results The area under the curve of CEUS combined with TI-RADS classification(AUC=0.900)was greater than that of conventional ultrasound combined with TI-RADS classification(AUC=0.808).The sensitivity,specificity,accuracy,positive and negative predictive values of conventional ultrasound combined with TI-RADS classification in the differential diagnosis of benign and malignant thyroid nodules were 81.6%(80/98),67.8%(40/59),76.4%(120/157),80.8%(80/99),68.9%(40/58),respectively.They were 98.0%(96/98),78.0%(34/59),90.4%(142/157),88.1%(96/109),95.8%(46/48),respectively for CEUS combined with TI-RADS classification.The sensitivity of CEUS combined with TI-RADS classification in the differential diagnosis of benign and malignant thyroid nodules was significantly higher than that of conventional ultrasound combined with TI-RADS classification(χ2=12.50,P<0.001).Conclusion CEUS combined with TI-RADS classification is more effective in the differential diagnosis of benign and malignant thyroid nodules than conventional ultrasound combined with TI-RADS classification.