首页|TI-RADS联合剪切波弹性成像在BSRTC Ⅲ类甲状腺结节中的意义

TI-RADS联合剪切波弹性成像在BSRTC Ⅲ类甲状腺结节中的意义

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目的:研究甲状腺影像报告和数据系统(TI-RADS)分类和剪切波弹性成像(SWE)方法在甲状腺细胞病理学Bethesda报告系统(BSRTC)Ⅲ类甲状腺结节良恶性诊断中的价值.方法:本研究回顾性分析 2019 年 6 月—2022 年 6 月在首都医科大学怀柔教学医院普外科接受甲状腺手术的 100 例甲状腺结节患者(123 个甲状腺结节)的临床资料.所有患者都接受了超声检查,并采用TI-RADS进行分类,同时在超声引导下进行甲状腺细针抽吸(FNA)活检及SWE,所有结节均采用BSRTC分析为Ⅲ类结节.以术后病理检查结果为金标准,分析TI-RADS和SWE单独及联合鉴别诊断BSRTC Ⅲ类甲状腺恶性结节的效能.结果:123个BSRTC Ⅲ类甲状腺结节经术后病理检查确诊有85个(69.11%)良性结节和38个(30.89%)恶性结节.TI-RADS诊断FNA活检意义不明确的甲状腺恶性结节的敏感度、特异度和准确度分别为 92.11%、70.59%、77.24%.SWE诊断FNA意义不明确的甲状腺恶性结节敏感度、特异度和准确度分别为 76.32%、95.29%、89.43%.TI-RADS和SWE联合诊断的AUC均显著大于TI-RADS和SWE单独诊断(ZTI-RADS=3.480,P=0.001;ZSWE=2.044,P=0.041).结论:TI-RADS联合SWE可以提高BSRTC Ⅲ类甲状腺恶性结节诊断效能,从而改善对BSRTC Ⅲ类甲状腺结节的治疗效果.
Significance of TI-RADS Combined with Shear Wave Elasto-graphy in BSRTC Ⅲ Thyroid Nodules
Objective:To study the value of thyroid imaging reporting and data system(TI-RADS)classification and shear wave elasto-graphy(SWE)in the diagnosis of benign and malignant Bethesda system for reporting thyroid cytopathology(BSRTC)Ⅲ thyroid nodules.Method:This study retrospectively analyzed the clinical data of 100 patients with thyroid nodules(123 thyroid nodules)who underwent thyroid surgery in Department of Functional,Huairou Teaching Hospital of Capital Medical University from June 2019 to June 2022.All patients underwent ultrasonography and were classified using TI-RADS.At the same time,ultrasond-guided thyroid fine-needle aspiration(FNA)biopsy and SWE were performed,and all nodules were analyzed as Ⅲ nodules using the BSRTC.The results of postoperative pathological examination as the gold standard,the efficacy of TI-RADS and SWE alone and combined in the differential diagnosis of BSRTC Ⅲ thyroid malignant nodules wear analyzed.Result:85 benign(69.11%)nodules and 38 malignant(30.89%)nodules of 123 BSRTC Ⅲ thyroid nodules were confirmed by postoperative pathological examination.The sensitivity,specificity and accuracy of TI-RADS respectively was 92.11%,70.59%and 77.24%in the diagnosis of thyroid malignant nodules with unclear significance of FNA biopsy.The sensitivity,specificity and accuracy of SWE respectively was 76.32%,95.29%and 89.43%in the diagnosis of thyroid malignant nodules with unclear significance of FNA biopsy.The AUC of TI-RADS and SWE combined diagnosis was significantly higher than those of TI-RADS and SWE alone diagnosis(ZTI-RADS=3.480,P=0.001,ZSWE=2.044,P=0.041).Conclusion:TI-RADS combined with SWE can improve the diagnostic efficiency of BSRTC Ⅲ thyroid malignant nodules,and thus improve the therapeutic effect of BSRTC Ⅲ thyroid nodules.

Fine-needle aspiration biopsyShear wave elasto-graphyThyroid imaging reporting and data systemBSRTC ⅢThyroid nodules

张国栋、李辉

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首都医科大学怀柔教学医院(北京怀柔医院)功能科 北京 101400

细针穿刺活检 剪切波弹性成像 甲状腺影像学报告和数据系统 甲状腺细胞病理学Bethesda报告系统Ⅲ类 甲状腺结节

2024

中国医学创新
中国保健协会

中国医学创新

影响因子:1.706
ISSN:1674-4985
年,卷(期):2024.21(5)
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