HT背景下桥本结节与甲状腺乳头状癌的超声征象与ACRTI-RADS评分的应用研究

Sonographic Signs and ACR of Hashimoto Nodules Versus Papillary Thyroid Carcinoma in the Setting of HT Application of the Ti-rads Score

目的 研究探讨HT背景下桥本结节与甲状腺乳头癌的超声征像以及甲状腺影像报告和数据系统的分级标准(ACR TI-RADS)评分的有效价值。方法 选取我院在2022年1月-2023年5月期间所接收和治疗经过甲状腺超声检验并且术后病理结果检验确诊为HT伴随结节的患者共82例,按照良性和恶性分为两组,分别为PTC组和NHT组。之后对比两组患者的超声征象以及ACR TI-RADS评分,并对恶性结节的AUC、敏感性、特异性以及准确性进行分析。结果 经过对比得知,一共110个结节,其中NHT40个,PTC 70个,两组结节在回声、边缘、局灶强回声、低回声晕方面的具有显著差异(P<0.05),而在成分、形态方面的没有明显差异(P>0.05)。ACR TI-RADS评分诊断HT背景下恶性结节敏感性、特异性、准确性分别为94.17%、62.38%、85.29%。结论 在HT背景下,NHT和PTC超声结果是不同的,ACR TI-RADS的评价可能更准确,但对PTC的诊断不够敏感,并可能导致部分NHT评估错误。此时应注意结节是否有点状强回声的恶性表现,或甲状腺外侧病变,以及周边低回声晕状态。

Objective To investigate the usefulness of ultrasound images of Hashimoto nodules versus papillary thyroid cancer and grading scale(ACR ti-rads)scores of the thyroid imaging reporting and data system in the context of HT.Methods 82 patients who received and treated in our hospital between January 2022 and May 2023 with concomitant nodules diagnosed as HT by thyroid ultrasound test and postoperative pathological results test were selected and divided into two groups according to benign and malignant,respectively,PTC group and NHT group.After that,the sonographic signs as well as ACR ti-rads scores were compared between the two groups,and the AUC,sensitivity,specificity as well as accuracy of the malignant nodules were analyzed.Results After being informed by the contrast,a total of 110 nodules,including 70 from nht40 and 70 from PTC,had significant differences(P<0.05)between the two groups in terms of echogenicity,margins,focal hyperechogenicity,hypoechogenic halos,and no obvious differences(P>0.05)in terms of composition,morphology.The sensitivity,specificity and accuracy of ACR ti-rads score for the diagnosis of malignant nodules in the context of HT were 94.17%,62.38%,85.29%,respectively.Conclusions In the context of HT,where NHT and PTC ultrasound results are different,the evaluation of ACR ti-rads may be more accurate,but is not sufficiently sensitive for the diagnosis of PTC and may lead to partial NHT evaluation errors.Attention should be paid at this time to whether the nodule has a malignant appearance with punctate hyperechogenicity,or a extrathyroidal lesion,as well as a peripheral hypoechoic halo state.