摘要
目的:评价基于甲状腺影像报告和数据系统(TI-RADS)的超声细化计分法和血清促甲状腺素(TSH)值联合对甲状腺结节良恶性进行鉴别诊断的意义。方法:选取进行甲状腺结节手术的病人,基于TI-RADS分级系统,根据超声图像中结节边界、纵横比、回声、钙化及颈部淋巴结对甲状腺结节进行细化计分,联合病人入院血清TSH值,绘制受试者工作特征曲线(ROC),计算ROC曲线下面积(AUC),评价超声细化计分法、血清TSH值和两者联合区分甲状腺良恶性结节的诊断价值。结果:ROC分析显示,超声细化计分法区分甲状腺良恶性结节的敏感度88.6%,特异度83.9%,AUC为0.779(95%CI:0.718~0.839),约登指数最大时,超声细化计计分法最佳临界值为9分,≥9分判定结节为恶性,<9分判定结节为良性;血清TSH值区分甲状腺良恶性结节的敏感度71.1%,特异度50.9%,AUC为0.703(95%CI:0.624~0.782),约登指数最大时取最佳临界值2.31 mIU/L;超声细化计分法与血清TSH值联合区分甲状腺良恶性结节的敏感度90.1%,准确度84.5%,特异度84.3%。结论:基于TI-RADS的超声细化计分法和血清TSH值联合鉴别甲状腺结节良恶性可使诊断符合率进一步提高,降低甲状腺结节的穿刺活检或手术率。
Objective:To assess the significance of ultrasonic refined scoring method based on thyroid imaging reporting and data system(TI-RADS)combined with serum thyroid stimulating hormone(TSH)level in the differentiation diagnosis of benign and malignant thyroid nodules.Methods:The refined scoring of the boundary,aspect ratio,echo and calcification of thyroid nodules in ultrasonoscopy in patients treated with operation based on TI-RADS grading system combined with serum level of TSH on admission were analyzed to draw the receiver operating characteristic(ROC)curve and calculate the area under ROC curve(AUC).The value of serum level of TSH,ultrasonic refined scoring method and both combination in the differentiation diagnosis of benign and malignant thyroid nodules were evaluated.Results:The ROC analysis showed that the sensitivity and specificity of ultrasonic refined scoring method in differentiating benign and malignant thyroid nodules were 88.6%and 83.9%,respectively.The AUC was 0.779(95%CI:0.718 to 0.839).When the Youden′s index was the largest,the optimal critical value of ultrasonic refined scoring method was 9 points,and the nodules with score≥9 and<9 points were malignant and benign,respectively.The sensitivity and specificity of serum level of TSH in distinguishing benign and malignant thyroid nodules were 71.1%and 50.9%,recpectively,and the AUC was 0.703(95%CI:0.624 to 0.782).When the Youden′s index was the largest,the optimal critical value was 2.31 mIU/L,and the sensitivity,accuracy and specificity of ultrasonic refined scoring method combined with serum TSH value in distinguishing benign and malignant thyroid nodules were 90.1%,84.5%and 84.3%,respectively.Conclusions:The ultrasonic refined scoring method based on TI-RADS combined with serum level of TSH in the differentiation diagnosis of benign and malignant thyroid nodules can further improve the diagnostic coincidence rate,and reduce the rate of thyroid nodule biopsy or operation.
作者
杨晓惠
YANG Xiao-hui(Department of Function,The Second Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233040,China)
出处
《蚌埠医学院学报》
CAS
2019年第6期771-773,777,共4页
Journal of Bengbu Medical College
关键词
甲状腺结节
超声细化计分法
甲状腺影像报告和数据系统
促甲状腺素
thyroid nodule
ultrasonic refined scoring method
thyroid imaging reporting and data system
thyroid stimulating hormone
