超声弹性成像联合S-Detect技术用于诊断TI-RADS4类甲状腺结节良恶性价值分析

Value of acoustic elastography combined with S-Detect technology in diagnosis of benign and malignant TI-RADS type 4 thyroid nodules

目的 探讨超声弹性成像(acoustic elastography, AE)联合S-Detect技术用于诊断甲状腺影像报告和数据系统(TI-RADS)4类甲状腺结节良恶性的价值。方法 选取许昌市人民医院2021年6月至2023年6月期间80例TI-RADS分类为4类的甲状腺结节患者(96个结节)为研究对象,均行AE及S-Detect技术诊断,以病理诊断为金标准,评价各检查方式鉴别结节良恶性的诊断效能。结果 96个结节的手术病理学检查结果显示,恶性结节64个(66.67%),良性结节32个(33.33%);64个恶性结节的AE评分平均为(4.31±0.83)分,32个良性结节的AE评分平均为(2.16±1.25)分,恶性结节AE评分显著高于良性结节(t=10.069,P<0.001);AE诊断结果与病理对照,共23个结节诊断存在差异,其中误诊8个,包括5个结节性甲状腺肿和3个滤泡性腺瘤,漏诊15个,包括9个乳头状甲状腺癌、5个滤泡型甲状腺癌和1个髓样癌;S-Detect技术诊断结果与病理对照,共15个结节存在差异,其中误诊5个,包括3个结节性甲状腺肿和2个滤泡性腺瘤,漏诊10个,包括6个乳头状甲状腺癌,3个滤泡型甲状腺癌和1个髓样癌;AE、S-Detect技术联合鉴别诊断TI-RADS 4类甲状腺结节良恶性的敏感度、特异度、准确度分别为95.31%、84.38%、91.67%,与病理诊断一致性检验Kappa值为0.81。结论 AE联合S-Detect技术在鉴别TI-RADS 4类甲状腺结节良恶性方面具有较高的效能,与病理诊断一致性良好。

Objective To explore the value of acoustic elastography(AE) combined with S-Detect technology in the diagnosis of benign and malignant thyroid imaging reporting and data system(TI-RADS) type 4 thyroid nodules.Methods Totally 80 patients with TI-RADS type 4 thyroid nodules(96 nodules) who admitted to Xuchang People's Hospital from June 2021 to June 2023 were selected as the study subjects. AE and S-Detect technology were used for diagnosis, and pathological diagnosis was used as the gold standard to evaluate the diagnostic efficiency of each examination method in differentiating benign and malignant nodules.Results Surgical pathological examination of 96 nodules showed 64 malignant nodules(66.67%) and 32 benign nodules(33.33%). The average AE score of 64 malignant nodules was(4.31±0.83) points, and that of 32 benign nodules was(2.16±1.25) points. The average AE score of malignant nodules was significantly higher than that of benign nodules(t=10.069, P<0.001). There were differences between AE diagnosis and pathology in 23 nodules, of which 8 nodules were misdiagnosed, including 5 nodular goiter and 3 follicular adenoma, and 15 nodules were missed, including 9 papillary thyroid carcinoma, 5 follicular thyroid carcinoma and 1 medullary carcinoma. S-Detect technology diagnosis were different from pathology in 15 nodules, among which 5 nodules were misdiagnosed, including 3 nodular goiter and 2 follicular adenomas, and 10 nodules were missed, including 6 papillary thyroid carcinoma, 3 follicular thyroid carcinoma and 1 medullary carcinoma. The sensitivity, specificity and accuracy of AE combined with S-Detect technology were 95.31%, 84.38% and 91.67% respectively in the differential diagnosis of TI-RADS type 4 thyroid nodules, and the Kappa value of consistency test with pathological diagnosis was 0.81.Conclusion AE combined with S-Detect technology has high efficiency in differentiating benign and malignant TI-RADS type 4 thyroid nodules, and it has good consistency with pathological diagnosis.