| 摘要: |
| 目的 探讨实时超声弹性成像(RTE)在调整中国甲状腺影像报告和数据系统(C-TIRADS)4类结节评级中的应用价值。方法 回顾性分析2016年1月至2019年12月扬州大学附属医院72例患者82个C-TIRADS 4类结节的临床资料,所有患者术前均行常规超声及RTE检查,根据结节最大径将结节分成≤10 mm和＞10 mm两组。采用Asteria RTE评分法,将RTE评分＜3分结节的C-TIRADS分类下调一级；评分≥3分的上调一级。以手术病理结果为金标准,绘制RTE调整前、后C-TIRADS分类的受试者工作特征(ROC)曲线,并比较两者的诊断效能。结果 RTE调整前、后C-TIRADS分类诊断良恶性甲状腺结节的灵敏度、特异度、准确度、阳性预测值及阴性预测值分别为90.4%、56.7%、78.0%、78.3%、77.3%和96.2%、80.0%、90.2%、89.3%、92.3%；其ROC曲线下面积分别为0.735和0.881(Z=2.869,P=0.004)。RTE对≤10 mm组及＞10 mm组结节调整后的诊断灵敏度、特异度、准确度、阳性预测值及阴性预测值分别为95.0%、80.0%、88.6%、86.4%、92.3%和96.9%、80.0%、91.5%、91.2%、92.3%。≤10 mm组及＞10 mm组结节RTE调整后的C-TIRADS分类对良恶性甲状腺结节的诊断效能均高于调整前,ROC曲线下面积分别为0.875和0.884,其中≤10 mm组RTE调整前后差异有统计学意义(Z=3.211,P=0.001)。结论 RTE对C-TIRADS 4类结节评级调整可显著提高其诊断效能,尤其对于≤10mm的C-TIRADS 4类结节。 |
| 关键词: 甲状腺结节 中国甲状腺影像报告和数据系统 实时弹性成像 |
| DOI： |
| 投稿时间：2022-03-31修订日期：2022-05-11 |
| 基金项目:扬州市科技局社会发展指导性项目(YZ2020099) |
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| The diagnostic value of ultrasound elastography in adjusting the classification of C-TIRADS 4 nodules |
| zhuminmin,Qi Tingyue,xuyan,xiaoxiao,rongxin,chenglian,caohaiyan,zhouqiwang,wanglei |
| (Department of Ultrasound, Medical Imaging Center, Affiliated Hospital of Yangzhou University) |
| Abstract: |
| Objective To investigate the diagnostic value of real-time ultrasound elastography (RTE) in adjusting the classification of Chinese thyroid imaging reporting and date system (C-TIRADS) classification 4 type nodules. Methods The clinical data of 82 C-TIRADS 4 nodules in 72 patients in the Affiliated Hospital of Yangzhou University from January 2016 to December 2019 were retrospectively analyzed. Conventional ultrasound and RTE examination were performed in all patients before surgery. The nodules were divided into ≤10 mm and >10 mm groups. Using the Asteria RTE scoring method, the C-TIRADS grade of RTE score <3 nodules were downgraded and the score ≥3 nodules were upgraded. The Receiver Operating Characteristic (ROC) curves of before and after RTE adjustments were drawn and the diagnostic efficacies were compared. Results The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of C-TIRADS in distinguishing benign and malignant thyroid nodules before and after RTE adjustment were 90.4%, 56.7%, 78.0%, 78.3%, 77.3% and 96.2%, 80.0%, 90.2%, 89.3%, 92.3%, respectively. The corresponding area under the ROC curves were 0.735 and 0.881, respectively (Z=2.869, P=0.004). The diagnostic sensitivity, specificity, accuracy, PPV and NPV were 95.0%, 80.0%, 88.6%, 86.4%, 92.3% in the ≤10 mm group and 96.9%, 80.0%, 91.5%, 91.2%, 92.3% in the >10 mm group, respectively. The corresponding ROC area under the curves were 0.875 and 0.884, respectively. For ≤10 mm group, the diagnostic efficacy of adjusted C-TIRADS had been significantly improved (Z=3.211, P=0.001). Conclusion C-TIRADS 4 nodules adjusted by RTE can significantly improve its diagnostic efficacy, especially for ≤10 mm nodules. |
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