ACR TI-RADS联合微血流成像鉴别甲状腺结节良恶性的价值

Value of ACR TI-RADS combined with micro-flow imaging in the differential diagnosis of benign and malignant thyroid nodules

目的探讨ACR TI-RADS联合微血流成像(MFI)鉴别诊断甲状腺结节良恶性的应用价值。方法分析我院经病理证实的97例甲状腺实性结节患者的二维超声及MFI图像资料,对97个甲状腺结节进行TI-RADS分类,比较良性组(41个)与恶性组(56个)临床资料和超声参数的差异。以病理结果为标准,绘制受试者工作特征(ROC)曲线分析单独TI-RADS、TI-RADS联合MFI鉴别诊断甲状腺结节良恶性的效能,比较二者的不必要穿刺率。结果良性组与恶性组性别、年龄、结节最大径、结节位置比较,差异均无统计学意义;良性组结节以Ⅱ型血流为主,恶性组结节以Ⅳ型血流为主,差异有统计学意义(P<0.01)。ROC曲线分析显示,TI-RADS联合MFI诊断甲状腺结节良恶性的曲线下面积为0.930,大于TI-RADS单独应用(0.864),差异有统计学意义(P<0.05)。TI-RADS单独应用时不必要穿刺率为27.8%(27/97),联合MFI后不必要穿刺率降为8.2%(8/97),差异有统计学意义(P<0.05)。结论ACR TI-RADS与MFI联合应用可有效提高对甲状腺结节良恶性的鉴别诊断效能,并减少了不必要穿刺,有一定的应用价值。

Objective To explore the application value of the ACR TI-RADS combined with micro-flow imaging(MFI)in the differential diagnosis of benign and malignant thyroid nodules.Methods The two-dimensional ultrasound and MFI image data of 97 patients with pathologically confirmed solid thyroid nodules from our hospital were analyzed,and the97 thyroid nodules were classified by TI-RADS,the differences in clinical data and ultrasonic parameters between the benign group(n=41)and malignant groups were compared(n=56).Taking pathological results as standard,the efficacy of TI-RADS alone and TI-RADS combined with MFI in the differential diagnosis of benign and malignant thyroid nodules was analyzed by receiver operating characteristic(ROC)curve,and the rate of unnecessary punctures between two was compared.Results The differences in gender,age,maximum diameter of nodule,and nodule location between the benign and malignant groups were not statistically significant.The nodules in the benign group mainly showed the blood flow of typeⅡ,while the nodules in the malignant group mainly showed the blood flow of typeⅣ,and the difference was statistically significant(P<0.01).ROC curve analysis showed that the area under the curve of TI-RADS combined with MFI in the diagnosis of benign and malignant thyroid nodules was 0.930,which was higher than that of TI-RADS alone(0.864),the difference was statistically significant(P<0.05).The rate of unnecessary puncture was 27.8%(27/97)by TI-RADS alone,and decreased to 8.2%(8/97)by TI-RADS combined with MFI,and the difference was statistically significant(P<0.05).Conclusion The combined application of ACR TI-RADS and MFI can improve the diagnostic efficiency of benign and malignant thyroid nodules and reduce the rate of unnecessary punctures.