王燕,金佳美,陈林,陈悦,詹嘉.超声联合硬度评分系统诊断TI-RADS[J].中国医学影像技术,2016,32(7):1039~1042
超声联合硬度评分系统诊断TI-RADS
United stiffness score system for diagnosis of TI-RADS 4 classification thyroid nodules
投稿时间:2015-12-08  修订日期:2016-05-14
DOI:10.13929/j.1003-3289.2016.07.013
中文关键词:  甲状腺结节  超声检查  联合硬度评分系统  弹性成像技术  声脉冲辐射力
英文关键词:Thyroid nodule  Ultrasonography  United stiffness score system  Elasticity imaging techniques  Acoustic radiation force impulse
基金项目:上海市科委医学引导类项目(14411970400)
作者单位E-mail
王燕 复旦大学附属华东医院超声科, 上海 200040  
金佳美 复旦大学附属华东医院超声科, 上海 200040  
陈林 复旦大学附属华东医院超声科, 上海 200040  
陈悦 复旦大学附属华东医院超声科, 上海 200040  
詹嘉 复旦大学附属华东医院超声科, 上海 200040 zj4977@citiz.net 
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中文摘要:
      目的 探讨超声联合硬度评分系统诊断甲状腺影像报告和数据系统(TI-RADS) 4类甲状腺结节的应用价值。方法 对105个接受手术切除并经病理证实的TI-RADS 4类甲状腺结节、术前分别行实时弹性成像和声脉冲辐射力成像测定其硬度。在此基础上,以联合硬度评分系统对甲状腺结节硬度进行评定,以硬度为依据,对甲状腺TI-RADS分类进行校正,以最终病理为标准,绘制ROC曲线,比较校正前后ROC曲线下面积。结果 TI-RADS分类校正前后诊断甲状腺结节的敏感度、特异度、阳性预测值、阴性预测值、准确率分别为40.50%(32/79)、92.30%(24/26)、94.11%(32/34)、33.80%(24/71)、53.33%(56/105)和73.41%(58/79)、88.46%(23/26)、95.08%(58/61)、52.27%(23/44)、77.14%(81/105)。ROC曲线下面积分别为0.66、0.84,二者差异有统计学意义(Z=10.85,P<0.001)。结论 联合硬度评分系统有助于提高对TI-RADS 4类甲状腺结节的鉴别诊断准确性。
英文摘要:
      Objective To explore the value of united stiffness score system (USSS) in the diagnosis of thyroid imaging reporting and data system (TI-RADS) 4 thyroid nodules. Methods A total of 105 TI-RADS 4 thyroid nodules underwent thyroidectomy and proved by the pathological results were included. Real-time elastography (RTE) and acoustic radiation force impulse (ARFI) were performed. USSS was taken to re-evaluate the stiffness of the thyroid nodules. Then TI-RADS classifications were adjusted according to USSS scores. The ROC curves were drawn to evaluate their accuracy according to the final pathological results. Results The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of TI-RADS classification for diagnosis of thyroid nudules were 40.50% (32/79), 92.30% (24/26), 94.11% (32/34), 33.80% (24/71) and 53.33% (56/105), respectively. After the correction of TI-RADS by USSS, these values were 73.41% (58/79), 88.46% (23/26), 95.08% (58/61), 52.27% (23/44) and 77.14% (81/105). The areas under the ROC curve were 0.66 and 0.84 before and after the correction and the difference was statistically significant (Z=10.85, P<0.001). Conclusion USSS is helpful in differential diagnosis of benign and malignant thyroid nodules of TI-RADS 4 classification.
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