811例甲状腺结节B超TI-RADS分级特征性分析与研究

Characteristic analysis of B-ultrasounds TI-RADS grading in 811 thyroid nodules

目的:探讨甲状腺癌B超TI-RADS分级与临床分期的相关性。方法:选取2015—2018年811例于我院手术治疗的甲状腺肿瘤患者,术前均于我院行甲状腺超声检查,并进行B超TI-RADS分级。分析B超TI-RADS分级与甲状腺癌病理类型及临床分期的相关性。结果:811例患者术前B超分级3级48例,4级712例(4a:255例,4b:318例,4c:139例),5级31例,6级20例。624例患者术后病理确诊为甲状腺癌,其中乳头状癌614例,滤泡状癌5例,未分化癌2例,髓样癌3例。B超TI-RADS分级与病理结果比对,良性结节符合率为24.1%;恶性结节符合率为99.5%;诊断甲状腺癌敏感性是81.4%,特异性是93.8%。术前B超发现甲状腺结节伴淋巴结肿大与术后确诊淋巴结转移显著相关。结论:B超TI-RADS分级对术前鉴别甲状腺结节良恶性、判断临床分期及选择手术方式具有临床价值。

Objective:To explore the correlation between TI-RADS grade of malignant degree of thyroid cancer and clinical stage.Methods:A total of 811 patients with thyroid tumors who underwent surgery in our hospital from 2015 to 2018 were selected.All patients underwent thyroid ultrasound examination in the ultrasound department of our hospital before the operation.The ultrasound signs include morphology,internal echo,calcification,and aspect ratio(A/T≥1),blood flow distribution,etc.,and perform ultrasound TI-RADS grade of malignancy,and analyze the B-ultrasound grade with postoperative pathological types and clinical stages,compare their correlations,and guide the choice of clinical surgical methods and prognosis evaluation.Results:624 of the 811 patients were pathologically diagnosed as thyroid cancer after surgery,including 614 cases of papillary carcinoma and 5 cases of follicular carcinoma,2 cases of undifferentiated carcinoma and 3 cases of medullary carcinoma.All patients underwent thyroid ultrasound examination in the ultrasound department of our hospital before the operation.Among them,571(75.5%)were female patients and 185(24.4%)were male patients;the youngest was 12 years old,the oldest was 78 years old,and the average was(49.8±20.9)years old.A total of 48 cases were preoperatively with B-ultrasound staging as level 3,712 cases with B-ultrasound staging as level 4(4a:255 cases,4b:318 cases,4c:139 cases),and B-ultrasound staging was 31 cases with level 5 and level 6 of 20 cases.Comparing TI-RADS classification with surgical pathological diagnosis results,the coincidence rate of benign nodules was 24.1%,the coincidence rate of malignant nodules was 99.5%,the sensitivity of diagnosis of thyroid cancer was 81.4%,the diagnosis specificity was 93.8%,and the preoperative B-ultrasound found thyroid nodules with lymph node enlargement are significantly related to the diagnosis of lymph node metastasis after surgery.Conclusion:Preoperative ultrasound TI-RADS grading of thyroid nodules has important significance in the identification of benign and malignant thyroid nodules,the judgment of clinical staging and the selection of surgical methods.