摘要
目的:分析比较超声造影(contrast-enhanced ultrasound,CEUS)、超声引导下细针穿刺活检(ultrasound-guided fine-needle aspiration biopsy,US-FNAB)及两者联合应用对甲状腺影像报告和数据系统(Thyroid Imaging Reporting and Data System,TI-RADS)4类结节的诊断价值.方法:回顾并分析2019年2月—2023年11月于唐山中心医院及唐山市工人医院有明确病理学检查结果的甲状腺TI-RADS 4类结节患者,以术后病理学检查结果为金标准,计算CEUS、US-FNAB及两者联合应用的诊断灵敏度、特异度、准确度、阳性预测值及阴性预测值,并绘制受试者工作特征(receiver operating characteristic,ROC)曲线对比其诊断效能.结果:在75例甲状腺TI-RADS 4类结节的良恶性鉴别诊断中,CEUS的诊断灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为70.7%、70.6%、70.6%、74.4%、66.7%;US-FNAB的诊断灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为75.6%、79.4%、77.3%、81.6%、73.0%;两者联合应用的诊断灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为97.6%、58.8%、80.0%、74.1%、95.2%.CEUS、US-FNAB及两者联合的假阳性率分别为29.3%、24.4%、2.4%;CEUS、US-FNAB及两者联合的假阴性率分别为29.4%、20.6%、41.2%.通过绘制ROC曲线得出,CEUS、US-FNAB及两者联合应用诊断的AUC分别为0.707、0.775、0.782.结论:CEUS及US-FNAB对甲状腺TI-RADS 4类结节良恶性的鉴别诊断均有一定价值,两者联合时可提高其诊断价值,临床中难以区分良恶性时,可将两者联合应用.
Abstract
Objective:To evaluate and compare the diagnostic value of contrast-enhanced ultrasound(CEUS),ultrasound-guided fine-needle aspiration biopsy(US-FNAB),and the combination of the two in the diagnosis of Thyroid Imaging Reporting and Data System(TI-RADS)4 nodules of the thyroid gland.Methods:Patients with TI-RADS 4 thyroid nodules having clear pathological findings from February 2019 to November 2023 in Tangshan Central Hospital and Tangshan Gongren Hospital were retrospectively analyzed.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of CEUS,US-FNAB,and the combination of the two methods were calculated by using postoperative pathology as a criterion,and the diagnostic efficacy of CEUS,US-FNAB and their combination was compared by drawing the receiver operating characteristic(ROC)curve.Results:In the differential diagnosis of seventy-five patients benign and malignant thyroid TI-RADS 4 nodules,the diagnostic sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of CEUS were 70.7%,70.6%,70.6%,74.4%,and 66.7%,respectively,and of US-FNAB were 75.6%,79.4%,77.3%,81.6%and 73.0%,respectively,and the combination of the two were 97.6%,58.8%,80.0%,74.1%,and 95.2%,respectively.The false-positive rates of CEUS,US-FNAB,and the combination of the two were 29.3%,24.4%,and 2.4%,respectively.The false-negative rates of CEUS,US-FNAB and the combination of the two were 29.4%,20.6%and 41.2%,respectively.The AUC of CEUS,US-FNAB and the combination of the two applied diagnostics were 0.707,0.775,and 0.782,respectively,as derived from plotting the ROC curve.Conclusion:Both CEUS and US-FNAB have a certain value in the differential diagnosis of benign and malignant thyroid TI-RADS 4 nodules,and their diagnostic value can be improved when they are combined,which can be combined when it is difficult to distinguish between benign and malignant in the clinical situation.
NETL
NSTL
万方数据