| 胡梅,李明星,王世界,杨涛.伴桥本甲状腺炎的甲状腺良恶性结节:超声特征及甲状腺超声征象报告与数据系统诊断价值[J].中国医学影像技术,2019,35(6):828~832 |
| 伴桥本甲状腺炎的甲状腺良恶性结节:超声特征及甲状腺超声征象报告与数据系统诊断价值 |
| Benign and malignant thyroid nodules with Hashimoto thyroiditis: Sonographic characteristics and diagnostic value of thyroid imaging reporting and data system |
| 投稿时间：2018-10-28 修订日期：2019-03-22 |
| DOI：10.13929/j.1003-3289.201810162 |
| 中文关键词: 桥本病 甲状腺结节 超声检查 |
| 英文关键词:Hashimoto disease thyroid nodule ultrasonography |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨伴桥本甲状腺炎（HT）的甲状腺良恶性结节超声表现特征以及美国放射学会（ACR）甲状腺超声征象报告与数据系统（TI-RADS）的诊断价值。方法 根据ACR TI-RADS回顾性分析129例HT合并208个甲状腺结节的声像图特征，包括结节成分、回声、形态、边缘及局灶性强回声。将病灶分为恶性组和良性组，对2组各超声征象进行统计学分析。以病理结果为金标准，获得ACR TI-RADS分类评分诊断伴HT甲状腺恶性结节的敏感度、特异度、准确率及AUC。结果 208个结节中，49个恶性结节，159个良性结节；2组成分、回声、形态、边缘、局灶性强回声差异均有统计学意义（P均<0.05）。2组局灶性强回声特征中，无强回声或大彗星尾、点状强回声钙化差异有统计学意义（χ2=57.29、64.87，P均<0.001），粗钙化、周围型钙化和混合钙化差异无统计学意义（P均>0.05）。ACR TI-RADS分类评分诊断甲状腺结节的AUC为0.924（P<0.01），敏感度、特异度、准确率分别为91.84%、84.27%、86.05%。结论 HT可能导致良性结节声像图特征趋向恶性；ACR TI-RADS鉴别伴HT良恶性甲状腺结节准确率较高。 |
| 英文摘要: |
| Objective To explore the sonographic characteristics of thyroid nodules under the background of Hashimoto's thyroiditis (HT), and to observe the value of the American College of Radiology (ACR) thyroid imaging reporting and data system (TI-RADS) in identifying benign and malignant thyroid nodules. Methods A total of 208 thyroid nodules with 129 patients under the background of HT were enrolled. The sonographic characteristics of nodules were investigated according to ACR TI-RADS, including composition, echogenicity, shape, margin and echogenic foci. The nodules were divided into malignant and benign groups. The ultrasonic signs of the two groups were statistically analyzed. The pathological results were used as the gold standard, and the sensitivity, specificity, accuracy and AUC of ACR TI-RADS classification score in diagnosis of malignant HT thyroid nodules were obtained. Results Of the 208 nodules in 129 patients, 49 were malignant and 159 benign nodules. There were significant differences in composition, echogenicity, shape, margin and echogenic foci in both groups (all P<0.05). For echogenic foci, no or big comet tail, point-like strong echo had statistical differences (χ2=57.29, 64.87, both P<0.001), while there was no statistical difference of microcalcifications, peripheral calcifications nor mixed calcifications (all P>0.05). AUC of ACR TI-RADS classification score in diagnosis of malignant HT thyroid nodules was 0.924 (P<0.01), the sensitivity, specificity, accuracy was 91.84%, 84.27% and 86.05%, respectively. Conclusion HT may make sonographic characteristics of benign nodules tend to be malignant. ACR TI-RADS has high accuracy in identifying benign and malignant thyroid nodules with HT. |
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