| 摘要: |
| 目的 探讨超声灰度比值(UGSR)在甲状腺皱缩结节(CTN)及甲状腺乳头状癌(PTC)中的鉴别效能及联合C-TIRADS的应用价值。方法 2018年1月至2022年12月在中国人民解放军东部战区总医院秦淮医疗区诊疗的PTC受试者86例(86枚结节)、CTN受试者78例(78枚结节)。比较结节位置、最大径、C-TIRADS阳性特征差异；测量结节整体灰度值、内部灰度值及边缘灰度值,计算UGSR并比较差异。采用Logistic回归分析筛选影响CTN的独立危险因素,绘制ROC曲线及计算曲线下面积(AUC)。使用UGSR重分析基于C-TIRADS的结节术前诊断,并评价效能。结果 与PTC相比,CTN在C-TIRADS阳性特征及整体灰度值中无显著差异(P＞0.05),而在内部灰度值、边缘灰度值及UGSR中具有显著性差异(P＜0.05)。Logistic回归分析显示UGSR是CTN的独立影响因素(OR=1.015,95%CI：0.995-1.026,P =0.007),且AUC最高(0.867)。与术前C-TIRADS评分相比,UGSR提高了C-TIRADS评分的准确性(PTC：χ2 =17.964,P =0.009；CTN：χ2 =10.904,P =0.010)。结论 UGSR具有良好的鉴别CTN与PTC的效能,并有效地提高了C-TIRADS诊断的准确性,值得在临床进一步推广。 |
| 关键词: 甲状腺皱缩结节 甲状腺乳头状癌 C-TIRADS 超声灰度比值 鉴别 |
| DOI： |
| 投稿时间：2023-08-20修订日期：2023-10-12 |
| 基金项目: |
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| The Application Value of Ultrasound Gray Scale Ratio Based on C-TIRADS Positive Features in Distinguishing Thyroid Contracted Nodules from Thyroid Papillary Cancer |
| Lv Ning,Tang Dandan,Yang Lu,Liu Yuanyuan,Cui Xiaomei,Huang Shengxi |
| (Department of special diagnosis and treatment,Eastern Theater Command General Hospital Qinhuai Medical Treatment Area of the Chinese People’s Liberation Army) |
| Abstract: |
| Objective To investigate the differential efficacy of ultrasound gray scale ratio (UGSR) in crumpled thyroid nodules (CTN) and papillary thyroid carcinoma (PTC) and the application value of combined C-TIRADS. Methods Eighty-six subjects with PTC (86 nodules) and 78 subjects with CTN (78 nodules) who were treated in Eastern Theater Command General Hospital Qinhuai Medical Treatment Area of the Chinese People’s Liberation Army from January 2018 to December 2022 were enrolled. Differences in nodule location, maximum diameter, and C-TIRADS positive features were compared; overall gray value, internal gray value, and edge gray value of nodules were measured, and UGSR was calculated and differences were compared. Logistic regression analysis was used to screen independent influencing factors on CTN, and ROC curves were plotted and area under the curve (AUC) calculated. Preoperative diagnosis of nodules based on C-TIRADS was reanalyzed using UGSR and efficacy was evaluated. Results Compared with PTC, CTN had no significant differences in C-TIRADS positive features and overall gray values (P > 0.05), while it had significant differences in internal gray values, marginal gray values and UGSR (P < 0.05). Logistic regression analysis showed that UGSR was an independent influence factor on CTN (OR = 1.015, 95% CI: 0.995-1.026, P=0.007) and had the highest AUC (0.867). UGSR improved the accuracy of the C-TIRADS score compared to the preoperative C-TIRADS score (PTC: χ2 =17.964, P=0.009; CTN: χ2 =10.904, P=0.010). Conclusion UGSR has good efficacy in distinguishing CTN from PTC and effectively improves the accuracy of C-TIRADS diagnosis, which is worthy of further promotion in the clinic. |
| Key words: Thyroid crumpling nodule papillary thyroid carcinoma C-TIRADS ultrasound gray scale ratio differentiation |
