超声C-TIRADS联合应变弹性成像在C-TIRADS 4类甲状腺结节良恶性评估中的应用价值

Application value of ultrasonic C-TIRADS combined with strain elastography inbenign and malignant assessment of C-TIRADS type 4 thyroidnodules

目的分析2020年版C-TIRADS分类联合应变弹性成像在C-TIRADS分类4类甲状腺结节良、恶性评估中的应用价值。方法回顾性分析2019年1月至2021年12月安徽医科大学第一附属医院诊治的173例C-TIRADS分类4类甲状腺结节病变患者,共211个结节。根据C-TIRADS分类、C-TIRADS分类和应变弹性评分联合(即校正C-TIRADS分类)2种分类方法对每个结节进行分类,以病理诊断结果为“金标准”,采用Kappa一致性检验和受试者工作特征曲线(ROC)2种方法来比较C-TIRADS分类以及校正C-TIRADS分类对C-TIRADS分类4类的甲状腺结节病变性质的诊断效能。结果病理结果显示,211个结节中100个为良性结节,111个为恶性结节。Kappa一致性检验结果显示,病理诊断和C-TIRADS分类Kappa系数为0.407(P<0.05),病理诊断和校正C-TIRADS分类的Kappa系数为0.741(P<0.05)。ROC曲线结果显示,C-TIRADS分类的灵敏度及特异度分别为78.37%和62.00%,曲线下面积为0.702;校正C-TIRADS分类的灵敏度、特异度分别为94.69%和79.00%,曲线下面积为0.868。结论2020年版C-TIRADS分类联合应变弹性成像能更好的评估C-TIRADS分类4类甲状腺结节的病变性质,具有更高的应用价值。

Objective To analyze the application value of C-TIRADS combined with strain elastography in benign and malignant evaluation of C-TIRADS type 4 thyroid nodules.Methods A retrospective analysis was performed on 173 patients with C-TIRADS type 4 thyroid nodular lesions diagnosed and treated in the Fourth Affiliated Hospital of Anhui Medical University from January 2019 to December 2021,with a total of 211 nodules.Each nodule was classified according to two classification methods:C-TIRADS classification,C-TIRADS classification and strain elasticity score combined(i.e.corrected C-TIRADS classification),and the pathological diagnosis results were used as the“gold standard”,and Kappa consistency test and receiver operating characteristic curve were used to compare the diagnostic efficacy of C-TIRADS classification and correction of C-TIRADS classification for the nature of thyroid nodules classified as type 4 by C-TIRADS.Results The pathological results showed that among the 211 nodules,100 were benign and 111 were malignant.The results of Kappa consistency test showed that the Kappa coefficient of pathological diagnosis and C-TIRADS classification was 0.407(P<0.05),and the Kappa coefficient of pathological diagnosis and corrected C-TIRADS classification was 0.741(P<0.05).The ROC curve results showed that the sensitivity and specificity of C-TIRADS classification was 78.37% and 62.00%,respectively,and the area under the curve was 0.702;the sensitivity and specificity of the corrected C-TIRADS classification was 94.69% and 79.00%,respectively,and the area under the curve was 0.868.Conclusions The 2020 C-TIRADS classification combined with strain elastography score can better evaluate the pathological properties of C-TIRADS type 4 thyroidnodules,which has higher application value.