中国超声甲状腺影像报告和数据系统联合弹性成像用于甲状腺结节性质的诊断价值

The diagnostic value of Chinese ultrasonic thyroid imaging report and data system combined with elastography on the nature of thyroid nodules

目的研究基于超声检查的中国超声甲状腺影像报告和数据系统(C-TIRADS)联合弹性成像用于甲状腺结节性质的诊断效果,为临床甲状腺结节性质的诊断提供参考。方法选取2021年1月至12月如皋市人民医院收治的50例甲状腺结节患者为研究对象进行回顾性分析,经病理诊断共95个结节,按病理诊断分为良性结节组(33个)和恶性结节组(62个)。在超声下对患者进行检查,并根据C-TIRADS分类系统对结节性质进行判断。比较甲状腺良恶性结节的C-TIRADS分类情况,比较甲状腺良恶性结节的超声弹性评分,以病理诊断结果为金标准,比较C-TIRADS、弹性成像及两者联合诊断甲状腺恶性结节的效能。结果良性结节组甲状腺结节C-TIRADS分类为3类的个数比例显著高于恶性结节组,C-TIRADS分类为4B、4C类的占比显著低于恶性结节组(P<0.05),两组甲状腺结节C-TIRADS分类为4A类、5类的占比比较,差异无统计学意义(P>0.05)。良性结节组甲状腺结节超声弹性评分为2分的个数比例显著高于恶性结节组,超声弹性评分为4分、5分的占比显著低于恶性结节组(P<0.05),两组甲状腺结节超声弹性评分为3分的占比比较,差异无统计学意义(P>0.05)。经一致性分析证实,C-TIRADS分类诊断甲状腺恶性结节的敏感度为77.42%,特异度为90.91%,准确率为82.11%;弹性成像诊断甲状腺恶性结节的敏感度为70.97%,特异度为87.88%,准确率为76.84%;C-TIRADS分类联合弹性成像诊断甲状腺恶性结节的敏感度为87.10%,特异度为90.91%,准确率为88.42%。结论C-TIRADS分类及弹性成像均能用于甲状腺结节良恶性的鉴别诊断,且两者联合对甲状腺性质的诊断效果较好,准确率较高,值得临床应用。

Objective To study the diagnostic effect of Chinese ultrasonic thyroid imaging reporting and data system C-TIRADS combined with elastography on the nature of thyroid nodules based on ultrasound,so as to provide reference for clinical diagnosis of the nature of thyroid nodules.Methods 50 patients with thyroid nodules admitted to The People’s Hospital of Rugao from January 2021 to December 2021 were selected for retrospective analysis.A total of 95 nodules were pathologically diagnosed,which were divided into benign nodules group(33 nodules)and malignant nodules group(62 nodules)according to pathological diagnosis.The patients were examined under ultrasound and the nature of the nodules were determined according to the C-TIRADS classification system.The C-TIRADS classification and ultrasound elasticity score were compared between the two groups.The pathological diagnosis results were taken as the gold standard,and the efficacy of C-TIRADS,elastography and their combination in the diagnosis of thyroid malignant nodules were compared.Results The proportion of C-TIRADS classified into 3 categories in benign nodules group were significantly higher than that in malignant nodules group,and the proportion of C-TIRADS classified into 4B and 4C categories were significantly lower than that in malignant nodules group(P<0.05).There were no significant differences between the two groups in the proportion of C-TIRADS classified into 4A and 5 categories(P>0.05).The proportion of thyroid nodules with ultrasonic elasticity score of 2 in benign nodule group were significantly higher than that in malignant nodule group,and the proportion of thyroid nodules with ultrasonic elasticity score of 4 and 5 were significantly lower than that in malignant nodule group(P<0.05).The consistency analysis confirmed that the sensitivity,specificity and accuracy of C-TIRADS classification in the diagnosis of thyroid malignant nodules were 77.42%,90.91%and 82.11%respectively.The sensitivity,specificity and accuracy of elastography in diagnosing thyroid malignant nodules were 70.97%,87.88%and 76.84%respectively.The sensitivity,specificity and accuracy of C-TIRADS classification combined with elastography in the diagnosis of thyroid malignant nodules were 87.10%,90.91%and 88.42%respectively.Conclusion Both C-TIRADS classification and elastography can be used for the diagnosis of benign and malignant thyroid nodules.However,the combination of C-TIRADS classification and elastography has a good diagnostic effect and high accuracy,which is worthy of clinical application.