| 摘要: |
| 目的 探讨C-TIRADS分类法与SWE技术定量法单独及联合应用对甲状腺不同大小良恶性结节的诊断效能。方法 选取有明确病理结果且术前有常规超声和剪切波弹性成像检查的甲状腺结节患者共139例，将结节按最大直径分为I组（≤10mm）和II组（＞10mm），分别进行C-TIRADS分类和测量结节弹性值，选取弹性测量稳定性最佳的指标，并以病理结果为金标准，分别绘制两组结节C-TIRADS分类、弹性测量值及两者联合诊断的ROC曲线，并确定良恶性最佳截断界值，采用Z检验法分别对两组结节三者的诊断效能进行两两比较。结果 I组结节AUC比较：C-TIRADS分类法（0.866）与Emax值定量法（0.840）比较差异无统计学意义（P＞0.05），C-TIRADS分类法（0.866）、Emax值定量法（0.840）与联合法（0.950）比较差异均有统计学意义（P＜0.05）；II组结节AUC比较：C-TIRADS分类法（0.932）与Emax值定量法（0.777）、Emax值定量法（0.777）与联合法（0.952）比较差异均有统计学意义（P均＜0.05），C-TIRADS分类法（0.932）与联合法（0.952）比较差异无统计学意义（P＞0.05）。本组资料C-TIRADS分类诊断4A类的恶性结节共5个，其中4个Emax值大于良恶性最佳截断界值（4/5个，占80%）。 结论 联合法可提升≤10mm的甲状腺结节良恶性的诊断效能；单独应用SWE技术定量法诊断＞10mm的甲状腺结节良恶性并不优于C-TIRADS分类法；SWE技术定量法可优化C-TIRADS 4A类结节。 |
| 关键词: 甲状腺结节 不同大小 C-TIRADS分类 剪切波弹性 |
| DOI： |
| 投稿时间：2023-02-15修订日期：2023-09-03 |
| 基金项目: |
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| Analysis of clinical application value of C-TIRADS classification combined with Shear wave elastography quantitative method in the diagnosis of thyroid nodules |
| heke,tangq |
| (Hainan Affiliated Hospital Of Hainan Medical University;The First Affiliated Hospital Of Guangzhou Medical University) |
| Abstract: |
| Objective To investigate the diagnostic efficacy of C-TIRADS classification and SWE quantitative technique alone and in combination for diagnosis of benign and malignant thyroid nodules of different sizes. Methods There were 139 cases of thyroid nodules who underwent conventional ultrasound and SWE confirmed by pathological, the nodules were divided into group I (≤10mm) and group II (>10mm) according to the maximum diameter, and carry out C-TIRADS classification and measure the elasticity value of nodules respectively and select the index with the best stability of elasticity measurement. The ROC curve of the C-TIRADS classification、the elasticity value and the combined diagnosis of the two groups was drawn respectively，and determine the best cut-off value for benign and malignant. Compared the diagnostic efficacy of the two groups of nodules according to Z test method. Results Comparison of AUC in Group I: there was no statistical difference between C-TIRADS classification (0.866) and Emax value quantitative method (0.840) (P>0.05), there was statistical difference between C-TIRADS classification (0.866) and combined method (0.950)、Emax value quantitative (0.840) and combined method (0.950) respectively (P＜0.05); Comparison of AUC in Group II: there was statistical difference between C-TIRADS classification (0.932) and Emax value quantitative method (0.777) 、Emax value quantitative (0.777) and combined method (0.952) respectively (P＜0.05), there was no statistical difference between C-TIRADS classification (0.932) and combined method (0.952) (P>0.05). The research show C-TIRADS classification diagnosis a total of 5 malignant nodules of category 4A, of which 4 have Emax values greater than the best cut-off value for benign and malignant (4/5, accounting for 80%). Conclusions The combined method could improve the diagnostic efficiency of ≤10mm benign and malignant thyroid nodules ; Application of SWE technology alone to diagnosis > 10mm benign and malignant thyroid nodules was not better than the C-TIRADS classification; SWE quantitative technology method could optimization C-TIRADS 4A nodules. |
| Key words: thyroid nodules different sizes C-TIRADS classification Shear wave elastography |
