| 贺亚萍,欧阳向柳,郑立春,夏永丽,韩泽朝,王庆文.中国版甲状腺影像报告和数据系统(C-TIRADS)联合结节内部及周围腺体硬度鉴别甲状腺良、恶性结节[J].中国医学影像技术,2024,40(1):37~41 |
| 中国版甲状腺影像报告和数据系统(C-TIRADS)联合结节内部及周围腺体硬度鉴别甲状腺良、恶性结节 |
| Chinese thyroid imaging reporting and data system (C-TIRADS) combined with intranodular and perinodular stiffness for distinguishing benign and malignant thyroid nodules |
| 投稿时间：2023-08-01 修订日期：2023-11-01 |
| DOI：10.13929/j.issn.1003-3289.2024.01.007 |
| 中文关键词: 甲状腺结节 超声检查 弹性成像技术 甲状腺影像报告和数据系统 |
| 英文关键词:thyroid nodule ultrasonography elasticity imaging techniques thyroid imaging reporting and data system |
| 基金项目:河北省医学科学研究课题计划（20231781）。 |
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| 中文摘要: |
| 目的 评估中国版甲状腺影像报告和数据系统（C-TIRADS）联合结节内部及周围腺体硬度鉴别甲状腺良、恶性结节的价值。方法 回顾性分析117例经细针抽吸细胞学检查（FNAC）和/或手术病理确诊甲状腺结节患者的常规超声及超声剪切波弹性成像（SWE）资料，按照C-TIRADS对结节进行分类；基于SWE技术测量结节及其周围2 mm腺体的SWE参数，包括甲状腺结节（E）及结节周围腺体（Eshell）杨氏模量值[最大值（Emax/Eshellmax）、平均值（Emean/Eshellmean）、最小值（Emin/Eshellmin）及标准差（ESD/EshellSD）]。绘制受试者工作特征（ROC）曲线，计算曲线下面积（AUC），评估C-TIRADS、SWE及二者联合鉴别甲状腺良、恶性结节的效能。结果 共纳入117例共117个甲状腺结节，包括良性结节50个、恶性结节67个。甲状腺恶性结节各SWE参数均高于良性结节（P均<0.001）。C-TIRADS鉴别甲状腺良、恶性结节的AUC为0.736，敏感度为79.10%、特异度为68.00%、准确率为74.36%；Emax、Emean、Emin及ESD的AUC分别是0.816、0.752、0.664及0.705，以Emax的AUC最高；Eshellmax、Eshellmean、Eshellmin及EshellSD的AUC分别为0.834、0.804、0.693及0.697，以Eshellmax的AUC最高，而与Emax差异无统计学意义（Z=1.044，P=0.297）。C-TIRADS+Emax和C-TIRADS+Eshellmax的AUC分别为0.835和0.843，其间差异无统计学意义（Z=0.574，P=0.566）但均高于C-TIRADS（AUC=0.736，Z=2.510、2.230，P均<0.05），二者诊断特异度及准确率均高于C-TIRADS（P均<0.05）。结论 C-TIRADS联合结节内部及其周围腺体硬度可有效鉴别良、恶性甲状腺结节，显著提高C-TIRDAS诊断效能。 |
| 英文摘要: |
| Objective To explore the value of Chinese thyroid imaging reporting and data system (C-TIRADS) combined with intranodular and perinodular stiffness for distinguishing benign and malignant thyroid nodules. Methods Data of routine ultrasound and ultrasonic shear wave elastography (SWE) in 117 patients with thyroid nodules confirmed by fine needle aspiration cytology (FNAC) and/or surgical pathology were retrospectively analyzed. The nodules were classified according to C-TIRADS and SWE parameters of nodules and surrounding 2 mm glands measured with SWE technique, including Young's modulus of thyroid nodules (E) and perinodular glandular (Eshell) (the maximum [Emax/Eshellmax], the mean [Emean/Eshellmean] and the minimum [Emin/Eshellmin] as well as standard deviation [ESD/EshellSD] values). Then receiver operating characteristic (ROC) curve was drawn, and area under the curve (AUC) was calculated to assess the efficacy of C-TIRADS, SWE and the combination for differentiating benign and malignant thyroid nodules. Results Totally 117 thyroid nodules of 117 patients were enrolled, including 50 benign and 67 malignant ones. SWE parameters of malignant thyroid nodules were higher than those of benign ones (all P<0.001). AUC of C-TIRADS for differentiating benign and malignant thyroid nodules was 0.736, with sensitivity of 79.10%, specificity of 68.00% and accuracy of 74.36%. AUC of Emax, Emean, Emin and ESD was 0.816, 0.752, 0.664 and 0.705, respectively, of Emax was the highest. AUC of Eshellmax, Eshellmean, Eshellmin and EshellSD was 0.834, 0.804, 0.693 and 0.697, respectively, of Eshellmax was the highest, which was not statistically difference with that of Emax (Z=1.044, P=0.297). AUC of C-TIRADS+Emax and C-TIRADS+Eshellmax was 0.835 and 0.843, respectively, being not significantly different (Z=0.574, P=0.566) but higher than that of C-TIRADS (AUC=0.736, Z=2.510, 2.230, both P<0.05), with diagnostic specificity and accuracy both higher than those of C-TIRADS (all P<0.05). Conclusion C-TIRADS combined with intranodular and perinodular stiffness could be used to effectively distinguish benign and malignant thyroid nodules, which might improve diagnostic efficiency of C-TIRDAS. |
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