超声造影联合超声组织触诊技术对TI-RADS4类甲状腺结节良恶性的诊断价值(1)
[摘要] 目的 探讨超声造影(CEUS)评分联合超声组织触诊技术对甲状腺影像报告和数据系统(TI-RADS)4类甲状腺结节的诊断价值。 方法 选取青海省人民医院常规超声归纳为TI-RADS 4类甲状腺结节患者62例为研究对象，术前行CEUS、声触诊组织成像技术(VTI)以及声触诊组织成像和定量技术(VTIQ)并获得剪切波速度(SWV)，以病理结果为金标准绘制受试者工作特征曲线，对比曲线下面积(AUC)，评价三种方法单一应用和联合应用对TI-RADS 4类结节的诊断价值。 结果 共计66个结节，恶性45个，良性21个。以4分为CEUS评分截断值，敏感性、特异性、准确性分别为86.7%、81.0%、84.8%;以Ⅳ级为VTI截断值，敏感性、特异性、准确性分别为84.4%、81.0%、83.3%;VTIQ技术中以SWV平均值2.70 m/s为截断值，敏感性、特异性、准确性分别为80.0%、85.7%、81.8%;三种方法联合应用的敏感性、特异性、准确性分别为93.3%、85.7%、90.9%。联合方法、CEUS评分、VTIQ技术及VTI的AUC分别为0.952、0.874、0.847、0.800。联合方法AUC最大，且联合方法的敏感性、准确性均较单一方法高，差异均有统计学意义(均P < 0.05)。 结论 CEUS评分联合VTI及VTIQ可显著提高对TI-RADS 4类甲状腺结节性质的判定，为恶性结节的检出提供影像参考依据。
[關键词] 超声造影;弹性成像;甲状腺影像报告和数据系统;甲状腺结节
[中图分类号] R445.1 [文献标识码] A [文章编号] 1673-7210(2020)08(a)-0140-04
[Abstract] Objective To investigate the diagnostic value of contrast-enhanced ultrasound (CEUS) score combined with ultrasound tissue palpation in thyroid imaging report and data system (TI-RADS) type 4 thyroid nodule. Methods A total of 62 patients with thyroid nodules of TI-RADS type 4 in Qinghai Provincial People′s Hospital were selected as the research objects. CEUS， virtual touch tissue imaging (VTI) and virtual touch tissue imaging quantification (VTIQ) were performed preoperatively and shear wave velocity (SWV) was obtained. The receiver operating characteristic curve was drawn with pathology results as the gold standard， and the area under the curve (AUC) was compared to evaluate the diagnostic value of single application and combined application of the three methods for TI-RADS type 4 nodules. Results There were 66 nodules， 45 malignant nodules and 21 benign nodules. The cutoff value of CEUS score was four scores， and the sensitivity， specificity and accuracy were 86.7%， 81.0% and 84.8%， respectively. Ⅳ level for VTI cutoff value， sensitivity， specificity and accuracy were 84.4%， 81.0% and 83.3%， respectively. The average value of SWV in VTIQ technology was 2.70 m/s as the cutoff value and the sensitivity， specificity and accuracy were 80.0%， 85.7% and 81.8%， respectively. The sensitivity， specificity and accuracy of the combined application of the three methods were 93.3%， 85.7% and 90.9%， respectively. The AUC of the combination method， CEUS score， VTIQ technique and VTI were 0.952， 0.874， 0.847 and 0.800， respectively. The AUC of the combined method was the largest， and the sensitivity and accuracy of the combined method were higher than those of the single method， the differences were all statistically significant (all P < 0.05). Conclusion CEUS score combined with VTI and VTIQ can significantly improve the determination of the thyroid nodule nature of TI-RADS 4， providing an imaging reference for the detection of malignant nodules., 百拇医药(李娜娜 张玉英 尹秋萍)
[關键词] 超声造影;弹性成像;甲状腺影像报告和数据系统;甲状腺结节
[中图分类号] R445.1 [文献标识码] A [文章编号] 1673-7210(2020)08(a)-0140-04
[Abstract] Objective To investigate the diagnostic value of contrast-enhanced ultrasound (CEUS) score combined with ultrasound tissue palpation in thyroid imaging report and data system (TI-RADS) type 4 thyroid nodule. Methods A total of 62 patients with thyroid nodules of TI-RADS type 4 in Qinghai Provincial People′s Hospital were selected as the research objects. CEUS， virtual touch tissue imaging (VTI) and virtual touch tissue imaging quantification (VTIQ) were performed preoperatively and shear wave velocity (SWV) was obtained. The receiver operating characteristic curve was drawn with pathology results as the gold standard， and the area under the curve (AUC) was compared to evaluate the diagnostic value of single application and combined application of the three methods for TI-RADS type 4 nodules. Results There were 66 nodules， 45 malignant nodules and 21 benign nodules. The cutoff value of CEUS score was four scores， and the sensitivity， specificity and accuracy were 86.7%， 81.0% and 84.8%， respectively. Ⅳ level for VTI cutoff value， sensitivity， specificity and accuracy were 84.4%， 81.0% and 83.3%， respectively. The average value of SWV in VTIQ technology was 2.70 m/s as the cutoff value and the sensitivity， specificity and accuracy were 80.0%， 85.7% and 81.8%， respectively. The sensitivity， specificity and accuracy of the combined application of the three methods were 93.3%， 85.7% and 90.9%， respectively. The AUC of the combination method， CEUS score， VTIQ technique and VTI were 0.952， 0.874， 0.847 and 0.800， respectively. The AUC of the combined method was the largest， and the sensitivity and accuracy of the combined method were higher than those of the single method， the differences were all statistically significant (all P < 0.05). Conclusion CEUS score combined with VTI and VTIQ can significantly improve the determination of the thyroid nodule nature of TI-RADS 4， providing an imaging reference for the detection of malignant nodules., 百拇医药(李娜娜 张玉英 尹秋萍)