摘要
目的探讨超声弹性成像对甲状腺C-TIRADS 4类结节分类校正及指导穿刺活检的价值。方法收集承德医学院附属医院2017年1月至2020年10月已行手术切除的甲状腺结节患者150例,共196个结节,全部为C-TIRADS 4类,超声弹性成像校正分类后,行常规超声及弹性成像引导下穿刺活检,获取穿刺活检结果与术后病理结果,分析超声弹性成像对C-TIRADS分类校正及指导穿刺活检价值。结果196个超声C-TIRADS 4类结节,其中C-TIRADS 4a级76例,C-TIRADS 4b级84例,C-TIRADS 4c级36例,经弹性成像校正分类后:C-TIRADS 3级4例,C-TIRADS 4a级54例,C-TIRADS 4b级94例,C-TIRADS 4c级40例,C-TIRADS 5级4例。与病理结果对照,C-TIRADS分类的诊断灵敏度为68.5%,特异度为60.0%,准确率为66.0%,AUC:0.642。弹性成像校正分类后的灵敏度为87.7%,特异度为80%,准确率为85.7%,AUC:0.838。二者之间差异有统计学意义(χ^(2)=24.814,P<0.05)。超声引导下穿刺活检的灵敏度为90.4%,特异度为90.0%,准确率为90.0%,AUC:0.902。弹性成像指导下穿刺活检的灵敏度为96.6%,特异度为94%,准确率为95.9%,AUC:0.953。二者之间差异有统计学意义(χ^(2)=80.410,P<0.05)。结论超声弹性成像对甲状腺C-TIRADS 4类结节的分类校正及指导穿刺活检具有一定的临床价值。
Objective To investigate the application value of ultrasound elastography in the correction of thyroid C-TIRADS 4 nodules and in guiding puncture biopsy.Methods A total of 150 patients with thyroid nodules who were treated by surgical resection in our hospital from January 2017 to October 2020 were enrolled in the study,including 196 nodules,all of which were TI-RADES 4.After correction classification of ultrasound elastography,puncture biopsy guided by conventional ultrasound and elastography was performed to obtain the puncture biopsy results and postoperative pathological results.The value of ultrasonic elastography in C-TIRADS grading correction and guiding needle biopsy was analyzed.Results Of the 196 ultrasonic C-TIRADS 4 nodules,there were 76 cases of C-TIRADS 4a,84 cases of C-TIRADS 4b,and 36 cases of C-TIRADS 4c,after being graded by elastography correction,there were 4 cases of C-TIRADS 3,54 cases of C-TIRADS 4a,94 cases of C-TIRADS 4b,40 cases of C-TIRADS 4c,and 4 cases of C-TIRADS 5.Compared with pathological results,the sensitivity,specificity,accuracy by C-TIRADS classification were 68.5%,60.0%and 66.0%respectively,with AUC being 0.642.After elastography correction classification,the sensitivity,specificity and accuracy were 87.7%,80%and 85.7%,respectively,with AUC being 0.838,and the differences between them were significant(P<0.05).The sensitivity,specificity and accuracy of ultrasound-guided needle biopsy were 90.4%,90.0%,and 90.0%,respectively,with AUC being 0.902,and the sensitivity,specificity and accuracy of elastography guided needle biopsy were 96.6%,94%,and 95.9%,respectively,with AUC being 0.953,and the differences between the two methods were significant(P<0.05).Conclusion The ultrasound elastography has certain clinical value in grading correction of thyroid C-TIRADS 4 nodules and guiding needle biopsy.
作者
丁华杰
那磊
杨绍石
李莎
史华宁
龚雪
DING Huajie;NA Lei;YANG Shaoshi(Affiliated Hospital of Chengde Medical College,Hebei,Chengde 067000,China)
出处
《河北医药》
CAS
2022年第18期2787-2789,2793,共4页
Hebei Medical Journal
基金
承德市科学技术研究与发展计划(编号:202006A044)。
