甲状腺轮辐状血流结节的超声诊断价值

Diagnostic Value of Ultrasound for Thyroid Nodules With a Spoke-Wheel Blood Flow Pattern

目的探讨超声对甲状腺轮辐状血流表现结节的诊断价值。方法收集超声检查甲状腺结节血流呈轮辐状表现患者的病例资料,记录结节灰阶超声特征,以病理结果为金标准,比较美国放射学会甲状腺影像报告与数据系统(ACR TI-RADS)和中国甲状腺影像报告与数据系统(C-TIRADS)及联合特异指标对甲状腺轮辐状血流结节的诊断效能。结果最终纳入患者64例,其中恶性结节47例,良性结节17例。除一般超声特征外,中央瘢痕多见于恶性结节(χ^(2)=5.968,P=0.015),而中央区粗钙化多见于良性结节(χ^(2)=10.899,P=0.001)。联合中央瘢痕和中央区粗钙化,ACR-TIRADS和C-TIRADS诊断甲状腺轮辐状血流结节的效能均明显提高(P均<0.001)。结论甲状腺结节超声呈轮辐状血流表现时应警惕恶性的可能,联合中央瘢痕及中央区粗钙化可提高超声诊断准确性。

Objective To explore the diagnostic value of ultrasound for thyroid nodules with a spoke-wheel blood flow pattern.Methods The clinical data of the patients with thyroid nodules presenting a spoke-wheel blood flow pattern examined by ultrasound were collected,and the gray-scale ultrasound features of the nodules were recorded.The diagnostic performance of the Thyroid Imaging Reporting and Data System by American College of Radiology(ACR TI-RADS),Chinese Thyroid Imaging Reporting and Data System(C-TIRADS),and combined specific indicators for the thyroid nodules with a spoke-wheel blood flow pattern was evaluated by comparison with the pathological results,which was regarded as the gold standard.Results A total of 64 patients with thyroid nodules were finally included,including 47 patients with malignant nodules and 17 patients with benign nodules.In addition to the general ultrasound features,central scar mostly appeared in malignant nodules(χ^(2)=5.968,P=0.015),while central coarse calcification was more common in benign nodules(χ^(2)=10.899,P=0.001).After the combination of central scar and central gross calcification,the diagnostic performance of ACR TI-RADS and C-TIRADS was improved(both P<0.001).Conclusions When the thyroid nodule shows a spoke-wheel blood flow pattern,one should be cautious of the possibility of malignancy.Combining central scar and central coarse calcification can improve the accuracy of ultrasonic diagnosis.