目的探讨甲状腺影像报告和数据系统（thyroid imaging reporting and data system,TI-RADS）在超声检查甲状腺结节中的诊断价值。方法收集292例（423个）甲状腺结节患者的超声资料,以组织病理学结果为参照标准,采用TI-RADS分级诊断标准...目的探讨甲状腺影像报告和数据系统（thyroid imaging reporting and data system,TI-RADS）在超声检查甲状腺结节中的诊断价值。方法收集292例（423个）甲状腺结节患者的超声资料,以组织病理学结果为参照标准,采用TI-RADS分级诊断标准进行回顾性评价。结果 423个甲状腺结节中,TI-RADS分级为1-5级者其恶性结节所占百分率分别为0（0/129）、6.3%（11/176）、33.3%（10/30）、86.8%（46/53）和100%（35/35）。对甲状腺良性结节超声检查TI-RADS分级的灵敏度、特异度、正确率、阳性预测值和阴性预测值分别为96.3%（309/321）、83.3%（85/102）、93.1%（394/423）、94.8%（309/326）和87.6%（85/97）,阳性似然比、阴性似然比及Youden指数分别为5.77、0.04和79.6%。TI-RADS分级的良、恶性结节在形态、边界、内部回声、回声质地、内部构成和钙化灶方面所占比例的差异均有统计学意义（P〈0.001）。结论在甲状腺结节的超声检查中,应用TI-RADS分级诊断标准对临床诊断和治疗具有重要的指导价值。展开更多
The role of vitamin D as an immune modulator has been emphasized in recent years,and low levels of the hormone were observed in several autoimmune diseases including multiple sclerosis and systemic lupus erythematosus...The role of vitamin D as an immune modulator has been emphasized in recent years,and low levels of the hormone were observed in several autoimmune diseases including multiple sclerosis and systemic lupus erythematosus.Vitamin D mediates its effect though binding to vitamin D receptor(VDR),and activation of VDR-responsive genes.While VDR gene polymorphism was found to associate with autoimmune thyroid diseases(AITDs),few studies examined levels of vitamin D in these patients and those that did yielded conflicting results.We therefore undertook to evaluate the levels of vitamin D in patients with AITDs compared to patients with non-AITDs and healthy controls.Serum vitamin D(25-OH)levels were measured in 50 patients with AITDs,42 patients with non-AITDs and 98 healthy subjects,utilizing the LIAISON chemiluminescence immunoassay(DiaSorin,Saluggia,Italy).VitaminD deficiency was designated at levels lower than 10 ng/ml.Antithyroid antibodies,thyroid functions and demographic parameters were evaluated in all patients.The prevalence of vitamin D deficiency was significantly higher in patients with AITDs compared with healthy individuals(72% versus 30.6%;P<0.001),as well as in patients with Hashimoto’s thyroiditis compared to patients with non-AITDs(79% versus 52%;P<0.05).Vitamin D deficiency also correlated to the presence of antithyroid antibodies(P=0.01)and abnormal thyroid function tests(P=0.059).Significantly low levels of vitamin D were documented in patients with AITDs that were related to the presence of anti thyroid antibodies and abnormal thyroid function tests,suggesting the involvement of vitamin D in the pathogenesis of AITDs and the advisability of supplementation.展开更多
文摘目的探讨甲状腺影像报告和数据系统（thyroid imaging reporting and data system,TI-RADS）在超声检查甲状腺结节中的诊断价值。方法收集292例（423个）甲状腺结节患者的超声资料,以组织病理学结果为参照标准,采用TI-RADS分级诊断标准进行回顾性评价。结果 423个甲状腺结节中,TI-RADS分级为1-5级者其恶性结节所占百分率分别为0（0/129）、6.3%（11/176）、33.3%（10/30）、86.8%（46/53）和100%（35/35）。对甲状腺良性结节超声检查TI-RADS分级的灵敏度、特异度、正确率、阳性预测值和阴性预测值分别为96.3%（309/321）、83.3%（85/102）、93.1%（394/423）、94.8%（309/326）和87.6%（85/97）,阳性似然比、阴性似然比及Youden指数分别为5.77、0.04和79.6%。TI-RADS分级的良、恶性结节在形态、边界、内部回声、回声质地、内部构成和钙化灶方面所占比例的差异均有统计学意义（P〈0.001）。结论在甲状腺结节的超声检查中,应用TI-RADS分级诊断标准对临床诊断和治疗具有重要的指导价值。
文摘The role of vitamin D as an immune modulator has been emphasized in recent years,and low levels of the hormone were observed in several autoimmune diseases including multiple sclerosis and systemic lupus erythematosus.Vitamin D mediates its effect though binding to vitamin D receptor(VDR),and activation of VDR-responsive genes.While VDR gene polymorphism was found to associate with autoimmune thyroid diseases(AITDs),few studies examined levels of vitamin D in these patients and those that did yielded conflicting results.We therefore undertook to evaluate the levels of vitamin D in patients with AITDs compared to patients with non-AITDs and healthy controls.Serum vitamin D(25-OH)levels were measured in 50 patients with AITDs,42 patients with non-AITDs and 98 healthy subjects,utilizing the LIAISON chemiluminescence immunoassay(DiaSorin,Saluggia,Italy).VitaminD deficiency was designated at levels lower than 10 ng/ml.Antithyroid antibodies,thyroid functions and demographic parameters were evaluated in all patients.The prevalence of vitamin D deficiency was significantly higher in patients with AITDs compared with healthy individuals(72% versus 30.6%;P<0.001),as well as in patients with Hashimoto’s thyroiditis compared to patients with non-AITDs(79% versus 52%;P<0.05).Vitamin D deficiency also correlated to the presence of antithyroid antibodies(P=0.01)and abnormal thyroid function tests(P=0.059).Significantly low levels of vitamin D were documented in patients with AITDs that were related to the presence of anti thyroid antibodies and abnormal thyroid function tests,suggesting the involvement of vitamin D in the pathogenesis of AITDs and the advisability of supplementation.
