超声TI-RADS分类联合剪切波式弹性成像对甲状腺结节良恶性的诊断价值

Value of ultrasound TI-RADS classification combined with shear wave elastography on the diagnosis of benign and malignant thyroid nodules

目的:分析超声甲状腺影像报告和数据系统(TI-RADS)分类联合剪切波式弹性成像(SWE)对甲状腺结节良恶性的诊断价值。方法:收集2017年1月至2020年1月行超声检查的甲状腺结节患者127例共145个结节,采用TI-RADS分类、SWE检查对结节的良恶性进行判定,分析TI-RADS分类联合SWE对甲状腺结节良恶性的诊断效能。结果:145个结节中病理检查共检出良性结节103个,恶性结节42个。TI-RADS分类(4b~5级为恶性结节)诊断甲状腺结节良恶性的敏感度为0.881,特异度为0.932。良性结节弹性模量低于恶性结节(P<0.05),SWE诊断甲状腺结节良恶性的ROC曲线的AUC(95%CI)为0.892(0.835~0.949);以弹性模量>49.88 kPa为恶性结节,SWE诊断的敏感度为0.857,特异度为0.825。以任一单独诊断为恶性即视为恶性结节为判定依据,TI-RADS分类联合SWE诊断甲状腺结节良恶性的敏感度为0.952,特异度为0.922。结论:TI-RADS分类联合SWE对甲状腺结节良恶性具有较高的诊断价值。

Aim:To analyze the value of ultrasound thyroid imaging-reporting and data system(TI-RADS)classification combined with shear wave elastography(SWE)on the diagnosis of benign and malignant thyroid nodules.Methods:A total of 127 patients(145 thyroid nodules)who underwent ultrasound examination were collected between January 2017 and January 2020.TI-RADS classification and SWE examination were used to determine the malignant thyroid nodules.The diagnostic efficacy of TI-RADS classification combined with SWE was analyzed.Results:A total of 103 benign nodules and 42 malignant nodules were identified pathologically among the 145 nodules.The sensitivity and specificity of TI-RADS classification for the benign and malignant diagnosis were 0.881 and 0.932.The elastic modulus value of benign nodules was significantly lower than that of the malignant nodules(P<0.05),and the AUC(95%CI)of ROC curve of SWE in the benign and malignant diagnosis was 0.892(0.835-0.949);when the nodule with the elastic modulus>49.88 kPa was defined as malignant,the sensitivity and specificity of SWE were 0.857 and 0.825.When either TI-RADS classification or SWE was diagnosed as malignant,the diagnosis result of TI-RADS classification combined with SWE was determined as malignant,the sensitivity and specificity were 0.952 and 0.922.Conclusion:TI-RADS classification combined with SWE has a high diagnostic value on the benign and malignant thyroid nodules.