| 汪延芳,聂芳,耿祥亮,宋爱琳.CEUS诊断TI-RADS 3、4级甲状腺结节[J].中国医学影像技术,2017,33(3):386~389 |
| CEUS诊断TI-RADS 3、4级甲状腺结节 |
| CEUS in diagnosis of TI-RADS 3, 4 thyroid nodules |
| 投稿时间：2016-08-29 修订日期：2016-12-19 |
| DOI：10.13929/j.1003-3289.201608130 |
| 中文关键词: 甲状腺影像报告与数据系统 超声造影 甲状腺乳头状癌 |
| 英文关键词:Thyroid imaging reporting and data system Contrast-enhanced Ultrasound Thyroid papillary carcinoma |
| 基金项目:兰州大学第二医院院内博士科研基金（[2015]151）。 |
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| 中文摘要: |
| 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TI-RADS 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（χ2=3.56，P=0.06）。对于直径>1 cm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≤ 1 cm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TI-RADS 3、4级结节具有校正及提高鉴别诊断的价值。 |
| 英文摘要: |
| 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, 4 nodules were analyzed. Results Compared with pathological pattern, conventional ultrasound TI-RADS classifications in assessing the property of thyroid nodule had no statistical differences (χ2=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 1 cm. But no statistical difference were found respectively (P=0.25, 1.00) for thyroid papillary carcinoma smaller than 1 cm. 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, 1 score, TI-RADS 4a respectively, 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. |
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