甲状腺影像报告与数据系统、声触诊组织量化技术及超声造影鉴别诊断甲状腺结节良恶性

目的探讨甲状腺影像报告与数据系统(TI-RADS)分类、声触诊组织量化(VTQ)技术及CEUS对甲状腺结节良恶性的鉴别诊断价值。方法对66例患者69个结节均于术前进行TI-RADS分类、CEUS,观察并分析其CEUS表现。采用VTQ测定结节剪切波速度(SWV),绘制ROC曲线获得SWV的曲线下面积及最佳临界值。计算3种方法单独及两两联合的敏感度、特异度、阳性预测值、阴性预测值及准确率。结果 69个甲状腺结节中,良性37个,恶性32个。3种方法单独诊断时,VTQ诊断甲状腺恶性结节的敏感度最高[87.50%(28/32)],CEUS特异度最高[91.89%(34/37)],两两联合应用时,VTQ和CEUS联合诊断甲状腺恶性结节的敏感度最高[93.75(30/32)]。SWV以2.55 m/s为最佳临界值,ROC曲线下面积为0.808(P0.01)。结论 3种方法均对诊断甲状腺结节良恶性有一定价值,VTQ联合CEUS的敏感度最高,是鉴别甲状腺结节良恶性的可靠检查手段。

Thyroid imaging reporting and data system, virtual tough tissues quantification technique and CEUS in differential diagnosis of benign and malignant thyroid nodules

Objective To assess value of thyroid imaging reporting and data system (TI-RADS), virtual tough tissues quantification (VTQ) and CEUS in differential diagnosis of benign and malignant thyroid nodules. Methods TI-RADS, VTQ and CEUS were performed in 69 thyroid nodules in 66 patients before operation. The manifestations of CEUS were observed and analyzed. VTQ was used to measure shear wave velocity (SWV). The area under the curve (AUC) and diagnostic cut-off point were obtained by ROC curve analysis. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of each and pairwise modality were calculated. Results In 69 thyroid nodules, 37 nodules were benign and 32 nodules were malignant. When three methods diagnosis separately, the sensitivity of VTQ in diagnosis of malignant thyroid nodule was the highest (87.50% [28/32]). The specificity of CEUS was the highest (91.89% [34/37]). When combined with two methods, the sensitivity of VTQ combined with CEUS in diagnosis of malignant thyroid nodule was highest (93.75% [30/32]). With a diagnostic cut-off value of 2.55 m/s for SWV value, AUC was 0.808 (P<0.01). Conclusion Three methods have some value in differential diagnosis of benign and malignant thyroid nodules. The sensitivity of VTQ combined with CEUS is the highest, which is the dependable method in differential diagnosis of benign and malignant thyroid nodules.