超声造影联合超声组织触诊技术对TI-RADS 4类甲状腺结节良恶性的诊断价值

摘要
图/表
参考文献(21)
相关文章 (15)

全文: PDF (571 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨超声造影（CEUS）评分联合超声组织触诊技术对甲状腺影像报告和数据系统（TI-RADS）4类甲状腺结节的诊断价值。方法选取青海省人民医院常规超声归纳为TI-RADS 4类甲状腺结节患者62例为研究对象，术前行CEUS、声触诊组织成像技术（VTI）以及声触诊组织成像和定量技术（VTIQ）并获得剪切波速度（SWV），以病理结果为金标准绘制受试者工作特征曲线，对比曲线下面积（AUC），评价三种方法单一应用和联合应用对TI-RADS 4类结节的诊断价值。结果共计66个结节，恶性45个，良性21个。以4分为CEUS评分截断值，敏感性、特异性、准确性分别为86.7%、81.0%、84.8%；以Ⅳ级为VTI截断值，敏感性、特异性、准确性分别为84.4%、81.0%、83.3%；VTIQ技术中以SWV平均值2.70 m/s为截断值，敏感性、特异性、准确性分别为80.0%、85.7%、81.8%；三种方法联合应用的敏感性、特异性、准确性分别为93.3%、85.7%、90.9%。联合方法、CEUS评分、VTIQ技术及VTI的AUC分别为0.952、0.874、0.847、0.800。联合方法AUC最大，且联合方法的敏感性、准确性均较单一方法高，差异均有统计学意义（均P ＜ 0.05）。结论 CEUS评分联合VTI及VTIQ可显著提高对TI-RADS 4类甲状腺结节性质的判定，为恶性结节的检出提供影像参考依据。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	李娜娜张玉英尹秋萍马钦风陈鲜霞李瑢应春花

关键词 ：超声造影, 弹性成像, 甲状腺影像报告和数据系统, 甲状腺结节

Abstract：Objective To investigate the diagnostic value of contrast-enhanced ultrasound (CEUS) score combined with ultrasound tissue palpation in thyroid imaging report and data system (TI-RADS) type 4 thyroid nodule. Methods A total of 62 patients with thyroid nodules of TI-RADS type 4 in Qinghai Provincial People′s Hospital were selected as the research objects. CEUS, virtual touch tissue imaging (VTI) and virtual touch tissue imaging quantification (VTIQ) were performed preoperatively and shear wave velocity (SWV) was obtained. The receiver operating characteristic curve was drawn with pathology results as the gold standard, and the area under the curve (AUC) was compared to evaluate the diagnostic value of single application and combined application of the three methods for TI-RADS type 4 nodules. Results There were 66 nodules, 45 malignant nodules and 21 benign nodules. The cutoff value of CEUS score was four scores, and the sensitivity, specificity and accuracy were 86.7%, 81.0% and 84.8%, respectively. Ⅳ level for VTI cutoff value, sensitivity, specificity and accuracy were 84.4%, 81.0% and 83.3%, respectively. The average value of SWV in VTIQ technology was 2.70 m/s as the cutoff value and the sensitivity, specificity and accuracy were 80.0%, 85.7% and 81.8%, respectively. The sensitivity, specificity and accuracy of the combined application of the three methods were 93.3%, 85.7% and 90.9%, respectively. The AUC of the combination method, CEUS score, VTIQ technique and VTI were 0.952, 0.874, 0.847 and 0.800, respectively. The AUC of the combined method was the largest, and the sensitivity and accuracy of the combined method were higher than those of the single method, the differences were all statistically significant (all P ＜ 0.05). Conclusion CEUS score combined with VTI and VTIQ can significantly improve the determination of the thyroid nodule nature of TI-RADS 4, providing an imaging reference for the detection of malignant nodules.

Key words： Contrast-enhanced ultrasound Elastography Thyroid imaging reporting and data system Thyroid nodule

基金资助:青海省卫生健康委科研指导性课题（2017-wjzdx-03）。

通讯作者: 张玉英（1962-），女，主任医师，青海省人民医院超声科主任；研究方向：甲状腺疾病。

作者简介: 李娜娜（1992-），女，青海大学医学院2017级影像医学与核医学专业在读硕士研究生；研究方向：超声新技术在甲状腺方面的应用。

引用本文:

李娜娜张玉英尹秋萍马钦风陈鲜霞李瑢应春花. 超声造影联合超声组织触诊技术对TI-RADS 4类甲状腺结节良恶性的诊断价值[J]. 中国医药导报, 2020, 17(22): 140-143.
LI Na′na ZHANG Yuying YIN Qiuping MA Qinfeng CHEN Xianxia LI Rong YING Chunhua. Diagnostic value of contrast-enhanced ultrasound combined with ultrasound tissue palpation for benign and malignant thyroid nodules of TI-RADS type 4. 中国医药导报, 2020, 17(22): 140-143.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I22/140

[1] Mohammadi M，Betel C，Burton KR，et al. Follow-up of Benign Thyroid Nodules-Can We Do Less? [J]. Can Assoc Radiol J，2019，70（1）：62-67.
[2] Tessler FN，Middleton WD，Grant EG，et al. ACR thyroid imaging，reporting and data system（TI-RADS）：white paper of the ACR TI-RADS committee [J]. J Am Coll Radiol，2017，14（5）：587-595.
[3] 付鹏，陈文，崔立刚，等.2017版美国放射学会甲状腺影像学报告与数据系统应用价值探索[J].北京大学学报：医学版，2019，51（6）：1067-1070.
[4] 商宁，杜辉，李军，等.超声造影联合弹性成像在TI-RADS 4类甲状腺结节良恶性鉴别诊断中的应用价值研究[J].中国医学装备，2017，14（1）：74-78.
[5] 许永波，姜珏，周琦，等.Logistic回归模型评价超声造影在甲状腺单发结节中的鉴别诊断价值[J].中国超声医学杂志，2013，29（4）：299-301.
[6] Gharib H，Papini E，Garber JR，et al. American Association of Clinical Endocrinologists，American College of Endocrinology，and Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules--2016 update [J]. Endocr Pract，2016，22（5）：622-639.
[7] 张蕾，郑超，勇强，等.常规超声联合超声造影计分法鉴别甲状腺微小结节良恶性的应用价值[J].中国超声医学杂志，2019，35（11）：969-973.
[8] Meena S，Meena S，Saini S. Follicular neoplasm of the thyroid：can clinical，ultrasonographical and cytological factors be used to predict carcinoma and determine extent of surgery [J]. Int Surg J，2019，6（11）：4038-4042.
[9] 牛卫东，赵诚，臧翊辰，等.甲状腺滤泡癌和滤泡性腺瘤的超声诊断与鉴别价值[J].中华临床医师杂志：电子版，2015，9（22）：4105-4109.
[10] 常淑娟，杨锦茹，吴成蓉，等.甲状腺髓样癌的超声特征分析[J].临床超声医学杂志，2019，21（4）：297-299.
[11] Lyu GR，Zheng WK，Lin WL，et al. Sonographic features of cervical lymph nodes in patients with Hashimoto thyroiditis and the impacts from the levothyroxine with prednisone therapy [J]. Ultrasound Q，2018，34（2）：67-70.
[12] 薛红元，姜紫韵，李丽，等.剪切波杨氏模量值在甲状腺结节良恶性诊断中的应用价值[J].疑难病杂志，2019， 18（8）：818-820，826.
[13] 乔妙，孙艳，侯新华，等.超声造影对桥本甲状腺炎背景下甲状腺良恶性结节的诊断效能[J].中国医学影像学杂志，2018，26（2）：104-108.
[14] 薛红元，姜紫韵，赵荣梅，等.超声造影在甲状腺结节良恶性诊断中的价值[J].疑难病杂志，2018，17（12）：1366-1369.
[15] Sachdev N，Sana SG，Prasad A. Clinical utility of TIRADS and ultrasound elastography in characterization of thyroid nodules [J]. Int J Res Med Sci，2019，7（2）：328.
[16] Xu JM，Xu HX，Zhang YF，et al. Virtual touch tissue imaging for differential diagnosis of thyroid nodules： additional value of the area ratio [J]. J Ultrasound Med，2016，35（5）：917-926.
[17] Hefeda MM. Value of the New Elastography Technique using Acoustic Radiation Force Impulse in Differentiation between Hashimoto′s Thyroiditis and Graves′ Disease [J]. J Clin Imaging Sci，2019，9：17.
[18] 孔德华，黄丽丽，周琦，等.甲状腺良恶性结节超声弹性成像的误诊分析[J].中国超声医学杂志，2014，30（11）：968-970.
[19] Hamidi C，G?觟ya C，Hattapo■lu S，et al. Acoustic Radiation Force Impulse（ARFI）imaging for the distinction between benign and malignant thyroid nodules [J]. Radiol Med，2015，120（6）：579-583.
[20] 吴墅，徐辉雄，徐军妹，等.声触诊组织成像和定量（VTIQ）技术对TI-RADS4（a-b）级甲状腺结节良恶性鉴别应用价值初步探讨[J].影像诊断与介入放射学，2015，24（5）：369-375.
[21] 刁雪红，詹嘉，陈林，等.声触诊组织成像定量技术鉴别诊断甲状腺结节良恶性的初步探讨[J].肿瘤影像学，2018，27（6）：504-508.