S-Detect联合SWE及ACR TI-RADS对甲状腺结节的诊断价值

Diagnostic Value of S-Detect Combined with SWE and ACR TI-RADS in Thyroid Nodules

目的比较单独应用S-Detect、剪切波弹性成像(SWE)、甲状腺影像报告和数据系统(ACR TI-RADS)及三者联合应用诊断甲状腺结节的效能。资料与方法回顾性选取2020年11月—2021年12月在合肥市第二人民医院行甲状腺常规超声同时行SWE和S-Detect的77例患者共98个结节,以病理结果为“金标准”,绘制S-Detect、SWE、ACR TI-RADS分级单独诊断和三者联合诊断的受试者工作特征曲线,比较各方法单独使用和联合使用的诊断效能。结果98个甲状腺结节中恶性结节55个(52.47%),良性结节43个(47.53%),S-Detect、SWE、ACR TI-RADS分级单独诊断与三者联合诊断甲状腺恶性结节的敏感度、特异度、准确度分别为89.09%、67.44%、79.59%,83.64%、74.42%、79.59%,69.09%、90.70%、78.57%,90.91%、88.37%、89.80%。联合诊断与单独应用ACR TI-RADS分级诊断的敏感度、S-Detect诊断的特异度比较,差异有统计学意义(P均<0.05);联合诊断后曲线下面积较单独诊断增高至0.956,与三者单独诊断的曲线下面积比较,差异均有统计学意义(P均<0.001);联合诊断Kappa系数为0.793,高于三者单独诊断。结论S-Detect、SWE、ACR TI-RADS分级三者联合应用可以提高对甲状腺结节良恶性的诊断效能,有效弥补S-Detect特异度较低、ACR TI-RADS分级敏感度较低的不足。

Purpose To compare the efficacy of S-Detect,shear wave elastography(SWE),and thyroid image reporting and data system(ACR TI-RADS)after combined application and alone in the diagnosis of thyroid nodules.Materials and Methods Ninety-eight nodules from 77 patients who underwent conventional ultrasound examination of the thyroid gland along with SWE and S-Detect in the Second People's Hospital of Hefei from November 2020 to December 2021 were retrospectively selected.Using the pathological findings as the gold standard,receiver operator characteristic curves were plotted for S-Detect,SWE,ACR TI-RADS grading,and combined diagnosis,then calculated and compared the diagnostic efficacy of diagnosis alone and combined diagnosis,respectively.Results Among 98 thyroid nodules,55(52.47%)were malignant nodules and 43(47.53%)were benign nodules.In diagnosing benign and malignant thyroid nodules,the sensitivity,specificity,and accuracy of S-Detect diagnosis were 89.09%,67.44%,and 79.59%,respectively,while the sensitivity,specificity,and accuracy of SWE diagnosis were 83.64%,74.42%,and 79.59%.The sensitivity,specificity and accuracy of ACR TI-RADS classification were 69.09%,90.70%,and 78.57%,respectively.The sensitivity,specificity,and accuracy of the combined diagnosis of the three methods were 90.91%,88.37%,and 89.80%,respectively.The difference in the sensitivity of the combined diagnosis of thyroid nodules compared with that of ACR TI-RADS alone was statistically significant(P<0.05);the difference in the specificity of the combined diagnosis of thyroid nodules compared with that of S-Detect alone was statistically significant(P<0.05);the area under curve increased to 0.956 after the combined diagnosis compared with that of the three alone,and there was statistically significant difference in area under curve between combined diagnosis and S-Detect,SWE as well as ACR TI-RADS,respectively(all P<0.001).The Kappa coefficient of the combined diagnosis was 0.793,which was all higher than that of three methods alone.Conclusion The combination of the S-Detect,SWE,and ACR TI-RADS grading should effectively improve the diagnostic efficacy of benign and malignant thyroid nodules,which effectively compensate for the disadvantage of a lower specificity of S-Detect,and also compensate for the deficiency of lower diagnostic sensitivity of ACR TI-RADS grading as much as possible.