摘要
目的探讨美国放射学会甲状腺影像报告和数据系统(ACR TI-RADS)分类联合实时剪切波弹性成像(RT-SWE)对甲状腺微小结节的诊断价值。方法对201个甲状腺微小结节行RT-SWE,以病理结果为金标准,绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),得出RT-SWE诊断甲状腺微小结节良恶性的最佳阈值。比较ACR TI-RADS分类、RT-SWE以及两者联合诊断甲状腺微小结节的灵敏度、特异度、准确度,分析RTSWE联合ACR TI-RADS对不同大小的甲状腺微小结节临床诊断价值。结果RT-SWE选取Emax=27.6 kPa为最佳阈值,ACR TI-RADS联合RT-SWE诊断甲状腺微小结节良恶性的灵敏度、特异度、准确度分别为91.91%、89.23%、91.04%,其AUC为0.92,明显大于ACR TI-RADS分类(0.80)、RT-SWE(0.84)单独诊断,差异均有统计学意义(Z分别=2.55、2.29,P均<0.05)。两者联合应用对0.5~1.0 cm组甲状腺微小结节诊断的灵敏度、准确度明显高于≤0.5 cm组,差异均有统计学意义(χ2分别=4.73、3.97,P均<0.05)。结论ACR TI-RADS分类联合RT-SWE可进一步提高甲状腺微小结节的诊断水平。
ObjectiveTo investigate the diagnostic value of thyroid imaging reporting and data system(ACR TI-RADS)combined with real-time shear wave elastography(RT-SWE)on thyroid micro-nodules.MethodsRT-SWE was performed on 201 thyroid micro-nodules. According to the gold standard of pathological results,ROC curve was drawn and AUC was calculated.The cut-off value of RT-SWE in diagnosing thyroid micro-nodules was obtained.The sensitivity,specificity and accuracy of ACR TI-RADS classification,RT-SWE and their combination in the diagnosis of thyroid micro-nodule were calculated,and the clinical diagnostic value of RT-SWE combined with ACR TI-RADS in different sizes of thyroid micro-nodule was analyzed.Results The cut-off value of RT-SWE in diagnosing thyroid micronodules was 27.6 k Pa,and the sensitivity,specificity and accuracy of ACR TI-RADS combined with RT-SWE in the diagnosis of benign and malignant thyroid micro-nodules were 91.91%,89.23%,91.04%,respectively.The AUC of ACR TI-RADS combined with RT-SWE in the diagnosis of benign and malignant thyroid micro-nodules was 0.92,which was significantly higher than that of ACR TI-RADS(0.80)and RT-SWE(0.84).The difference was statistically significant(Z=2.55,2.29,P<0.05).The sensitivity and accuracy of the combined application of ACR TI-RADS and RT-SWE for thediagnosis of thyroid micro-nodules with the diameter of 0.5~1.0 cm patients were significantly higher than those of patients whose thyroid micro-nodules with the diameter≤0.5 cm,the difference was statistically significant(χ~2=4.73,3.97,P<0.05).Conclusion ACR TI-RADS combined with RT-SWE can improve the diagnosis of thyroid micro-nodules.
作者
张玮
张珍东
杨成梁
欧阳萱艺
朱长玉
ZHANG Wei;ZHANG Zhendong;YANG Chengliang(Department of Ultrasound,Jiaxing Second Hospital,Jiaxing 314000,China)
出处
《全科医学临床与教育》
2020年第3期226-229,共4页
Clinical Education of General Practice
基金
嘉兴市科技局公益类研究项目(2019AD32139)。
