声触诊组织成像和定量技术联合ACR TI-RADS分类对不同直径甲状腺结节的诊断价值

 目的 探讨声触诊组织成像和定量（virtual touch tissue imaging quantification，VTIQ）技术联合美国放射学会（American College of Radiology，ACR）颁布的甲状腺影像报告与数据系统（thyroid imaging-reporting and data system，TI-RADS）对不同直径（diameter，D）甲状腺结节的诊断价值。方法 回顾性分析2018年3月至2020年3月于华东疗养院行甲状腺超声检查并经术后病理证实的122例患者共137个甲状腺结节的常规超声和VTIQ图像资料，所有结节按ACR TI-RADS分类进行评分。结节根据最大直径分为D≤10 mm组和D > 10 mm组。通过Spearman相关性分析评估结节ACR TI-RADS分类与VTIQ技术之间的相关性。利用二元Logistic回归分析生成ACR TI-RADS分类联合VTIQ技术诊断甲状腺结节的恶性预测概率模型，以手术病理为金标准，绘制受试者工作曲线，比较VTIQ技术、ACR TI-RADS分类以及两者联合对甲状腺结节的诊断效能。结果 在评估甲状腺结节良恶性上，VTIQ技术与ACR TI-RADS分类呈中度相关（D > 10 mm组：r=0.656，P < 0.001；D≤10 mm组：r=0.615，P < 0.001）。ACR TI-RADS分类、VTIQ技术和两者联合诊断甲状腺结节的曲线下面积分别为0.828、0.819、0.889（D > 10 mm组）和0.802、0.807、0.827（D≤10 mm组）。结论 VTIQ技术联合ACR TI-RADS分类可提高甲状腺结节的诊断效能，无论是单独应用VTIQ技术、ACRTI-RADS分类，还是两者的联合应用，诊断效能在D > 10 mm组均稍具优势。

Diagnostic value of virtual touch tissue imaging quantification combined with ACR TI-RADS in thyroid nodules with different diameters

Objective To investigate the value of virtual touch tissue imaging quantification (VTIQ) and thyroid imaging-reporting and data system (TI-RADS) issued by the American College of Radiology(ACR) in diagnosing thyroid nodules with varied diameter (D).Methods The conventional ultrasound and VTIQ images of 137 thyroid nodules in 122 patients who underwent thyroid ultrasound examination in Huadong Sanatorium from Mar 2018 to Mar 2020 and confirmed by pathology results were analyzed retrospectively.All nodules were categorized in ACR TI-RADS definition.Nodules were divided into two groups according to the maximum diameter (D≤10 mm group and D > 10 mm group).The relationship between ACR TI-RADS classification of nodules and VTIQ technique was evaluated by Spearman correlation analysis.Two-way Logistic regression analysis was used to predict malignancy.Pathology results were regarded as a gold standard, receiver operator characteristic (ROC) was drawn, and the diagnostic efficacy of VTIQ, ACR TI-RADS classification and their combination for thyroid nodules was compared.Results VTIQ and ACR TI-RADS classification were moderately correlated with malignancy of thyroid nodules (D > 10 mm group: r=0.656, P < 0.001;D≤10 mm group: r=0.615, P < 0.001). The areas under the curve (AUC) of ACR TI-RADS classification, VTIQ technique and their combination in diagnosis of thyroid nodules were 0.828, 0.819 and 0.889 in D > 10 mm group and 0.802, 0.807, and 0.827 in D≤10 mm group.Conclusion VTIQ can improve the diagnostic efficiency of malignancy of thyroid nodules, especial with ACR TI-RADS classification.VTIQ, ACR TI-RADS and the combination are all slightly superior D > 10mm group compared to the D≤10 mm group.