TI-RADS联合超声造影在甲状腺良恶性结节鉴别诊断中的应用价值

摘要

目的:旨在分析甲状腺影像学报告数据系统(TI-RADS)、超声造影(CEUS)及两者联合运用在甲状腺良恶性结节鉴别诊断中的应用价值.方法:选取重庆市中医院2015年1月~2016年12月收治的87例甲状腺结节患者作为研究对象,患者均行CEUS、TI-RADS及两者联合检查,以手术病理学检查结果为金标准,比较3种检查方式的甲状腺良恶性结节灵敏度、特异度及准确率.结果:87例患者中共有117个甲状腺结节,良性结节95个,恶性结节22个,结节最大直径0.54~5.19 cm,平均直径(1.50±0.76)cm;TI-RADS分级诊断甲状腺良恶性结节灵敏度、特异度、准确度分别为45.45%(10/22)、64.21%(61/95)、60.68%(71/117);甲状腺良恶性结节在早期增强强度、增强均匀、周边环状增强图像中存在明显差异(P<0.05),CEUS诊断甲状腺良恶性结节灵敏度、特异度、准确度分别为72.72%(16/22)、92.63%(88/95)、91.45%(104/117);72.72%(16/22)、74.73%(71/95)、74.35%(87/117);95.45%(21/22)、31.57%(30/95)、43.58%(51/117);TI-RADS分级联合CEUS诊断甲状腺良恶性结节灵敏度、特异度、准确度分别为90.90%(20/22)、95.78%(91/95)、94.87% (111/117).结论:TI-RADS联合CEUS可有效提高甲状腺良恶性结节鉴别诊断的灵敏度、特异度及准确率.%Objective To analyze the application value of thyroid imaging reporting and data system(TI-RADS),contrast-enhanced ultrasonography(CEUS),and combined use of them in the differential diagnosis of benign and malignant thyroid nodules. Methods Eighty-seven patients with thyroid nodules treated in Chongqing Traditional Chinese Medicine Hospital from January 2015 to December 2016 were selected as the subjects.All the patients were examined by CEUS,TI-RADS and combined examination.Taken the operational and pathological results as the gold standard,we compared the sensitivity,specificity and accuracy of the 3 examination methods for the differential diagnosis of benign and malignant thyroid nodules.Results There were 117 thyroid nodules,95 benign nodules and 22 malignant nodules in 87 patients.The maximum diameter of nodules was 0.54-5.19 cm,and the average diameter was(1.50+0.76)cm.The sensitivity,specificity and accuracy of TI-RADS in the diagnosis of benign and malignant thyroid nodules were 45.45%(10/22),64.21%(61/95)and 60.68%(71/117),respectively.The imaging characteristics of benign and malignant thyroid nodules were significantly different in early enhancement, homogeneous enhancement,and peripheral ring enhancement images(P<0.05).The sensitivity,specificity and accuracy of CEUS in the diagnosis of benign and malignant thyroid nodules were 72.72% (16/22), 92.63% (88/95) and 91.45%(104/117) on early enhancement images;72.72%(16/22),74.73%(71/95)and 74.35%(87/117)on homogeneous enhancement images;and 95.45% (21/22)and 31.57%(30/95)and 43.58%(51/117)on peripheral ring enhancement images.The sensitivity,specificity and accuracy of TI-RADS combined with CEUS in the diagnosis of benign and malignant thyroid nodules were 90.90%(20/22), 95.78% (91/95)and 94.87%(111/117).Conclusion TI-RADS combined with CEUS can effectively improve the sensitivity,specificity and accuracy of the differential diagnosis of benign and malignant thyroid nodules.