超声造影评分法联合中国版甲状腺影像报告与数据系统分类在甲状腺结节良恶性鉴别中的应用价值

Application value of contrast-enhanced ultrasound scoring combined with Chinese version of thyroid imaging reporting and data system in the differential diagnosis of thyroid nodules

目的探讨超声造影(CEUS)评分法联合中国版甲状腺影像报告与数据系统(C-TIRADS)分类对甲状腺结节良恶性的鉴别诊断价值。方法选取郑州大学第一附属医院2019年6月至2020年12月收治的55例甲状腺恶性结节、79例甲状腺良性结节进行C-TIRADS分类和CEUS评分,以病理结果为金标准,绘制受试者工作特征(ROC)曲线,比较C-TIRADS分类、CEUS评分法及两者联合对甲状腺结节的诊断效能。结果C-TIRADS分类的最佳分类阈值为4B类,CEUS评分的最佳评分阈值为3分。CEUS评分联合C-TIRADS分类的ROC曲线的曲线下面积(AUC,0.926)高于单独应用C-TIRADS分类(0.837)和CEUS评分(0.863)(Z=3.564,P<0.001;Z=2.869,P=0.004)。联合诊断的敏感性(94.6%)高于单独应用C-TIRADS分类(81.8%)和CEUS评分(80.0%)(P=0.039,P=0.022);联合诊断的特异性(87.3%)高于单独应用C-TIRADS(70.9%)(P=0.001),而与CEUS评分的特异性(83.5%)比较差异无统计学意义(P=0.250)。结论CEUS评分法可以显著提高C-TIRADS分类的诊断效能,两者联合拥有较高的临床价值。

Objective To explore the value of Chinese version of Thyroid Imaging Reporting and Data System(C-TIRADS)combined with contrast-enhanced ultrasound(CEUS)scoring in the differential diagnosis of thyroid nodules.Methods All the 55 thyroid malignant nodules and 79 benign nodules in the First Affiliated Hospital of Zhengzhou University from Jun 2019 to Dec 2020 were performed C-TIRADS classification and CEUS scoring.With pathological results taken as the gold standard,receiver operator characteristic(ROC)curve were used to compare the efficiency of C-TIRADS classification,CEUS scoring and the combination of the two methods in the differential diagnosis of thyroid nodules.Results The best classification threshold of C-TIRADS was 4B,and the best scoring threshold of CEUS was 3 points.The area under the curve(AUC)of CEUS score combined with C-TIRADS classification(0.926)was higher than those of C-TIRADS classification(0.837)and CEUS scoring(0.863),the difference was statistically significant(Z=3.564,P<0.001;Z=2.869,P=0.004).The sensitivity of combined methods(94.6%)was higher than those of C-TIRADS classification(81.8%)and CEUS scoring(80.0%),the difference was statistically significant(P=0.039,P=0.022).The specificity of combined methods(87.3%)was higher than that of C-TIRADS(70.9%),the difference was statistically significant(P=0.001),and there was no statistically significant difference in specificity of compared methods and CEUS scoring(83.5%)(P=0.250).Conclusion CEUS scoring can significantly improve the diagnostic efficiency of C-TIRADS,and the combination of the two methods has the high clinical value.