甲状腺影像报告与数据系统联合超声微血管成像对甲状腺结节良恶性的鉴别诊断价值
Value of TI-RADS combined with superb micro-vascular imaging in the differential diagnosis of benign and malignant thyroid nod-ules
许锦富 1罗彩媚 1张海春2
作者信息
- 1. 广东医科大学附属东莞第一医院(东莞市东南部中心医院)超声医学中心 广东 东莞 523710
- 2. 广东省第二人民医院超声医学中心 广东 广州 510317
- 折叠
摘要
目的 探讨甲状腺影像报告与数据系统(TI-RADS)联合超声微血管成像(SMI)对甲状腺结节良恶性的鉴别诊断价值.方法 回顾性纳入2021年1月至2023年12月就诊于东莞市东南部中心医院的112例甲状腺结节患者,所有患者术前均进行常规超声检查及SMI检查,依据常规超声行TI-RADS分级.以病理检查为金标准,对比以上两种检查方式单独及联合诊断对甲状腺结节的鉴别价值,绘制受试者操作特征(ROC)曲线验证检查的诊断价值.结果 本研究112例(112个结节)患者中,良性结节70个(62.50％),恶性结节42个(37.50％).112个结节中,TI-RADS分类诊断为1类、2类、3类、4类及5类结节数分别为11、32、25、16及28个.112个结节中,SMI技术诊断为0、1级、2级及3级的结节数分别为40、25、12及35个.以病理结果为金标准,TI-RADS分类诊断误诊16例,漏诊14例;SMI误诊13例,漏诊8例.二者联合的敏感度及阴性预测值均高于单独TI-RADS分类及SMI技术,差异有统计学意义(P＜0.05);二者联合的准确性高于单独TI-RADS分类,差异有统计学意义(P＜0.05).ROC曲线显示,二者联合时对甲状腺恶性结节的诊断价值最高,此时曲线下面积(AUC)为0.874,95％CI为0.771～0.905.结论 TI-RADS与SMI二者联合能进一步提高甲状腺结节诊断的敏感度与准确性,可为临床医师的医疗决策提供更多参考.
Abstract
Objective To investigate the value of thyroid imaging reporting and data system(TI-RADS)combined with superb micro-vascular imaging(SMI)in the differential diagnosis of benign and malignant thyroid nodules.Methods One hundred and twelve patients with thyroid nodules admitted to the Southeast Central Hospital,from January 2021 to December 2023 were retorspectively selected.All patients were examined by conventional ultrasound and SMI before operation,and TI-RADS grading was performed according to conventional ultrasound.The surgical pathological results was taking as the gold standard,the differential value of the above two examination methods alone and in combination for thyroid nodules was compared,and the diagnostic value of the examination was verified by plotting the receiver operating characteristic(ROC)curve.Results Among the 112 patients(112 nodules)in this study,70 nodules(62.50％)were benign nodules and 42 nodules(37.50％)were malignant nodules.Among the 112 nodules,the number of TI-RADS classified as type 1,type 2,type 3,type 4 and type 5 nodules was 11,32,25,16 and 28 nodules,respectively.Among the 112 nodules,the number of nodules diagnosed as 0,grade 1,grade 2 and grade 3 by SMI technique was 40,25,12 and 35 nodules,respectively.With pathological results as the gold standard,16 cases were misdiagnosed and 14 cases were missed by TI-RADS classification.SMI was misdiagnosed in 13 cases and missed in 8 cases.The sensitivity and negative predictive value of the combination of the two were higher comparing with TI-RADS classification and SMI alone,the difference was statistically significant(P＜0.05).The accuracy of the combination of the two was higher comparing with the single TI-RADS classification,the difference was statis-tically significant(P＜0.05).ROC curve showed that the combination of the two had the highest diagnostic value for malignant thyroid nodules,with an area under the curve(AUC)of 0.874 and 95％CI of 0.771-0.905.Conclusion Both TI-RADS and SMI have high diagnostic value in the differential diagnosis of benign and malignant thyroid nodules.The combined diagnosis of the two can further improve the sensitivity and ac-curacy of diagnosis,which can provide more reference for clinicians'medical decision-making.
关键词
甲状腺结节/超声检查/诊断,鉴别/良恶性/甲状腺影像报告与数据系统/超声微血管成像Key words
Thyroid nodules/Ultrasonography/Diagnosis,differentid/Benign and malignant/Thyroid imaging reporting and data sys-tem/Superb micro-vascular imaging引用本文复制引用
基金项目
东莞市社会科技发展项目(20211800904202)
广东省基础与应用基础研究基金委员会(2023A1515011950)
出版年
2024
NETL
NSTL
万方数据