超声微血流成像联合弹性成像评分对甲状腺TI-RADS 4类结节良恶性的鉴别诊断价值

Value of ultrasound micro-blood flow imaging combined with elastography score in differential diagnosis of benign and malignant TI-RADS 4 thyroid nodules

目的探讨超声微血流成像技术联合弹性成像评分对超声甲状腺影像报告与数据系统(TI-RADS)4类结节良恶性的鉴别诊断价值。方法回顾性选取2020年1月至2020年12月在杭州市中医院超声科进行甲状腺结节检查的患者136例,共141个TI-RADS 4类结节,所有结节均同时完成超声弹性成像及微血流成像检查,记录其微血流成像评分、弹性成像评分以及联合评分,并与甲状腺细针穿刺和手术病理结果进行对照,构建ROC曲线分析比较微血流成像评分、弹性成像评分及两者联合评分法对TI-RADS 4类甲状腺结节良恶性的鉴别诊断效能。结果ROC曲线结果显示,联合评分法的诊断敏感度、准确性(86.4%、82.98%)高于微血流成像评分(65.05%、64.54%)和弹性成像评分(75.73%、74.47%),差异均有统计学意义(P均<0.05)。联合评分法ROC曲线下面积为0.800,大于弹性成像评分(0.734)和微血流成像评分(0.641),差异均有统计学意义(P均<0.05)。结论超声微血流成像和弹性成像联合评分,能提高TI-RADS 4类甲状腺结节良恶性的鉴别诊断价值,为临床选择治疗方案提供一定的参考。

Objective To investigate the value of ultrasound micro-blood flow imaging combined with elastography score in the differential diagnosis of benign and malignant Ultrasound Thyroid Imaging Reporting and Data System(TI-RADS)4 thyroid nodules.Methods A total of 136 patients who underwent thyroid nodule examination at the ultrasound department of Hangzhou Hospital of Traditional Chinese Medicine from January 2020 to December 2020 were retrospectively selected.There were 141 TI-RADS 4 thyroid nodules.All nodules underwent ultrasound elastography and micro-blood flow imaging at the same time to record their micro-blood flow imaging score,elastography score,and the combined score.The diagnostic results based on these scores were compared with thyroid fine needle aspiration and surgical pathology results.Receiver operating characteristic(ROC)curve analysis was performed to assess the performance of micro-blood flow imaging score,elastography score,and the combined score in the differential diagnosis of benign and malignant TI-RADS 4 thyroid nodules.Results ROC curve analysis showed that the diagnostic sensitivity and accuracy of the combined score(86.4%,82.98%)were significantly higher than those of the micro-blood flow imaging(65.05%,64.54%)and elastography(75.73%,74.47%)(P<0.05).The area under the ROC curve of the combined score was 0.800,which was higher than those of elastography score(0.734)and micro-blood flow imaging score(0.641)(P<0.05).Conclusion Ultrasound micro-blood flow imaging combined with elastography can improve the differential diagnosis of benign and malignant TI-RADS 4 thyroid nodules,and provide some reference for clinical treatment options.