摘要
目的:探究多模态超声在诊断甲状腺影像报告和数据系统(TI-RADS)4类甲状腺结节中的临床应用效果。方法:回顾性分析行甲状腺结节切除术的86例患者的临床资料,术前均行多模态超声检查,以病理诊断结果为金标准,评估多模态超声参数诊断甲状腺癌的一致性,比较不同TI-RADS分类患者多模态超声参数[收缩期峰值流速、舒张末期流速、阻力指数、Adler分级、弹性应变率比值(SR)、弹性评分]差异,分析多模态超声参数对甲状腺癌的诊断效能。结果:86例患者中TI-RADS 3类37例,TI-RADS 4类49例,恶性36例,良性50例,超声诊断甲状腺癌的敏感度、特异度分别为88.88%、66.00%,Kappa=0.522;TI-RADS 4类组收缩期峰值流速、舒张末期流速、阻力指数、SR值、弹性评分均高于TI-RADS 3类组(P<0.05),两组间Adler分级差异有统计学意义(P<0.05);收缩期峰值流速、舒张末期流速、阻力指数、Adler分级、SR值、弹性评分诊断甲状腺癌的曲线下面积(AUC)分别为0.956、0.912、0.941、0.916、0.914、0.921,联合诊断的AUC为0.967(P<0.05)。结论:多模态超声在TI-RADS 4类甲状腺结节的诊断中具有较高的诊断效能,值得推广应用。
Objective:To explore the clinical application effect of multimodal ultrasound in the diagnosis of thyroid imaging reporting and data system(TI-RADS)category 4 thyroid nodules.Methods:The clinical data of 86 patients who underwent thyroid nodule resection were retrospectively analyzed.All patients underwent multimodal ultrasound examination before surgery.According to the results of pathological diagnosis,the consistency of multimodal ultrasound parameters in the diagnosis of thyroid cancer was evaluated.The differences in multimodal ultrasound parameters[peak systolic velocity,end diastolic velocity,resistance index,Adler grading,strain ratio(SR),elasticity score]were compared among patients with different TI-RADS classification,and the diagnostic efficiency of multimodal ultrasound parameters in the diagnosis of thyroid cancer was evaluated.Results:Among the 86 patients,there were 37 cases of TI-RADS category 3 and 49 cases of TI-RADS category 4,and there were 36 malignant cases and 50 benign cases.The sensitivity,specificity and Kappa value of ultrasound in the diagnosis of thyroid cancer were 88.88%,66.00%and 0.522.The peak systolic velocity,end diastolic velocity,resistance index,SR and elasticity score in TI-RADS category 4 group were higher than those in TI-RADS category 3 group(P<0.05),there was a statistical significance in Adler grading between the two groups(P<0.05).The AUC of peak systolic velocity,end diastolic velocity,resistance index,Adler grading,SR and elasticity score in the diagnosis of thyroid cancer were 0.956,0.912,0.941,0.916,0.914 and 0.921 respectively,and the AUC of combined diagnosis was 0.967(P<0.05).Conclusion:Multimodal ultrasound has a high diagnostic efficiency in the diagnosis of TI-RADS category 4 thyroid nodules and is worthy of promotion and application.
作者
李维芝
崔蕾
彭雪艳
朱文峰
LI Wei-zhi;CUI Lei;PENG Xue-yan;ZHU Wen-feng(Department of Diagnostic Ultrasonography,Xianyang Central Hospital,Xianyang 712000,Shaanxi,China;Medical Imaging Centre,Xianyang Central Hospital,Xianyang 712000,Shaanxi,China)
出处
《川北医学院学报》
CAS
2024年第6期758-761,共4页
Journal of North Sichuan Medical College
基金
陕西省自然科学基础研究计划项目(2014JM2-8202)。
