摘要
目的探讨CEUS对甲状腺TI-RADS 3、4级结节的诊断价值。方法回顾性分析95例常规超声诊断为TIRADS 3、4级的甲状腺结节(共95个结节,均经手术病理证实)的CEUS表现,分析CEUS对甲状腺TI-RADS 3、4级结节的校正及鉴别诊断价值。结果常规超声TI-RADS分级评估甲状腺结节良恶性与手术病理级型比较,差异无统计学意义(χ~2=3.56,P=0.06)。对于直径>1cm的甲状腺TI-RADS 3、4级结节,与常规超声TI-RADS分级相比,CEUS评分及CEUS校正后TI-RADS分级的诊断准确率差异均有统计学意义(P=0.03、<0.01);对于直径≤1cm的微小乳头状癌,差异均无统计学意义(P=0.25、1.00)。ROC曲线分析显示,对于甲状腺TI-RADS 3、4级结节,常规超声TI-RADS分级、CEUS评分、CEUS校正后TI-RADS分级的ROC曲线下面积分别为0.64、0.75、0.81时,截断值分别为TI-RADS 4a级、1分、TI-RADS 4a级,评估结节良、恶性的敏感度、特异度分别为45.3%、80.0%,69.3%、65.0%,82.7%、60.0%。CEUS评分、CEUS校正后TI-RADS分级与常规超声TI-RADS分级的曲线下面积的差异有统计学意义(P均<0.05),CEUS评分与CEUS校正后TI-RADS分级的曲线下面积差异无统计学意义(P=0.23)。结论 CEUS对甲状腺TIRADS 3、4级结节具有校正及提高鉴别诊断的价值。
Objective To explore the diagnostic value of CEUS for thyroid TI-RADS 3,4 nodules.Methods The CEUS performence of 95 patients with thyroid TI-RADS 3,4 nodules（all were confirmed by surgery pathology）diagosed by conventional ultrasound were reviewed retrospectively,and the value of CEUS in the revision and differential diagnosis of thyroid TI-RADS 3,4nodules were analyzed.Results Compared with pathological pattern,conventional ultrasound TIRADS classifications in assessing the property of thyroid nodule had no statistical differences（χ~2=3.56,P=0.06）.For thyroid TI-RADS 3,4 nodules,compared with conventional ultrasound TI-RADS classifications,the diagnosis accuracy of CEUS score and revised CEUS TI-RADS classifications showed significant differeces respectively（P=0.03,〈0.01）for thyroid papillary carcinoma greater than 1cm.But no statistical difference were found respectively（P=0.25,1.00）for thyroid papillary carcinoma smaller than 1cm.According to the ROC curve analysis,the area under the curve of traditional ultrasound TI-RADS classifications,CEUS score and revised CEUS TI-RADS classifications were 0.64,0.75,0.81 respectively,cut-off value was TI-RADS 4a,1score,TI-RADS 4arespectively,the sensitivity and specificity of evaluating benign and malignant nodules was 45.3% and 80.0%,69.3% and 65.0%,82.7% and 60.0%,respectively.The area under the ROC curve were statistical difference between CEUS score,revised CEUS TI-RADS classifications and conventional ultrasound TI-RADS classifications（both P〈0.05）,while CEUS score and revised CEUS TI-RADS classifications without statistical difference.Conclusion CEUS had the revised and improved identification value for thyroid TI-RADS 3,4 nodules.
出处
《中国医学影像技术》
CSCD
北大核心
2017年第3期386-389,共4页
Chinese Journal of Medical Imaging Technology
基金
兰州大学第二医院院内博士科研基金([2015]151)
关键词
甲状腺影像报告与数据系统
超声造影
甲状腺乳头状癌
Thyroid imaging reporting and data system
Contrast-enhanced Ultrasound
Thyroid papillary carcinoma
