甲状腺影像报告和数据系统与声触诊组织量化成像技术在甲状腺微小癌的诊断价值  

Value of thyroid imaging reporting and data system and virtual touch tissue imaging quantification for diagnosing thyroid microcarcinoma

作　　者：沈燕[1,2] 徐辉雄 张一峰[1] 徐军妹[1] 李小龙[1] 刘博姬[1] 房林 曲伸[4] 

机构地区：[1]同济大学附属第十人民医院超声医学科暨同济大学医学院超声医学研究所,上海200072 [2]浦东新区公利医院超声科,上海200135 [3]同济大学附属第十人民医院甲状腺乳腺外科,上海200072 [4]同济大学附属第十人民医院内分泌与代谢科,上海200072

出　　处：《影像诊断与介入放射学》2015年第6期460-464,共5页Diagnostic Imaging & Interventional Radiology

基　　金：国家自然科学基金(81401417);上海市人才发展基金(2012045);上海市科委生物医药领域科技支撑项目(14441900900);上海申康医院发展中心市级医院适宜技术联合开发应用推广项目(SHDC12014229)

摘　　要：目的探讨甲状腺影像报告和数据系统（TI-RADS）、声触诊组织量化成像（VTIQ）技术及两者联合应用在诊断甲状腺微小癌中的价值。方法回顾性分析2014年7月~2015年1月我院经手术后病理证实的84例患者88个甲状腺微小结节的TI-RADS与VTIQ图像资料。先行常规超声检查,对结节进行TI-RADS分级,然后测量结节在VTIQ上的剪切波速度（SWV）,获取SWV最大值、最小值、平均值（单位m/s）。以手术病理结果为金标准,计算超声TI-RADS、VTIQ技术及两者联合应用诊断甲状腺微小癌的敏感度、特异度、阳性预测值、阴性预测值,行ROC分析。结果 88个结节中,恶性结节47个,良性结节41个。TI-RADS诊断恶性结节37个,良性结节51个,VTIQ技术诊断恶性结节49个,良性结节39个,两者联合诊断恶性结节53个,良性结节35个。TI-RADS诊断TMC敏感度72.34%、特异度92.68%、阳性预测值91.89%,阴性预测值74.51%。VTIQ诊断TMC敏感度为87.23%,特异度80.49%,阳性预测值83.67%,阴性预测值84.62%。两者联合的敏感度达95.74%,特异度80.49%,阳性预测值84.90%,阴性预测值94.28%。TI-RADS分级、VTIQ技术以及两者联合应用诊断甲状腺微小癌的ROC曲线下面积分别为0.825、0.839、0.880。结论由于高频超声的运用,甲状腺微小癌的检出率不断提高,而超声TI-RADS分级联合VTIQ技术可进一步提高甲状腺微小癌的诊断水平。Objective To evaluate the value of thyroid imaging reporting and data system.（TI-RADS）.and virtual touch tissue quantification（VTIQ） for diagnosing thyroid microcarcinoma. Methods From July 2014 to January 2015, the ultrasound data of 84 patients with 88 pathological confirmed nodules ≤10 mm（41 benign, 47 malignant） were analyzed prospectively. The TI-RADS and VTIQ features were summarized. The region of interest（ROI） was placed according to the VTIQ quality mode with breath-holding. Receiver operating characteristic（ROC） curve was plotted to determine the most accurate SWV value and the cutoff value for differential diagnosis..Using surgical pathology as the gold standard,.the diagnostic sensitivity,.specificity,.positive predictive value（PPV） and negative predictive value（NPV） of TI-RADS, VTIQ and their combination were calculated. The ROC curves of TI-RADS,.VTIQ and their combination were drawn..The areas under the ROC curves were calculated. Results Of 88 nodules, 37 were classified as malignant and 51 as benign by TI-RADS with 72.34% sensitivity, 92.68% specificity, 91.89% PPV and 74.51% NPV. 49 nodules were classified as malignant and 39 as benign by VTIQ with 87.23% sensitivity, 80.49% specificity,83.67% PPV and 84.62% NPV. 53 nodules were classified as malignant and 35 as benignby combined TI-RADS and VTIQ with95.74% sensitivity, 80.49% specificity, 84.90% PPV and 94.28% NPV. The areas under the ROC curves of TI-RADS, VTIQ and their combination were 0.825, 0.839, and 0.880, respectively. Conclusion VTIQ can be used as an adjunct of the TI-RADS for diagnosing thyroid microcarcinoma.

关 键 词：甲状腺微小结节 超声检查 TI-RADS分级 弹性成像技术 

分 类 号：R736.1[医药卫生—肿瘤]