TI-RADS联合SMI技术对甲状腺良恶性结节的鉴别诊断价值  

Value of TI-RADS combined with SMI in differential diagnosis of malignant and benign of thyroid nodules

作　　者：李小娟[1] 温德惠[1] 张利英 刘翔宇[1] 李月华 武宇宏[2] LI Xiaojuan;WEN Dehui;ZHANG Liying;LIU Xiangyu;LI Yuehua;WU Yuhong(Department of Ultrosonography,First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China;Department of Otolarygology Head and Neck Surgery,First Affiliated Hospital of Hebei North University)

机构地区：[1]河北北方学院附属第一医院超声医学科,张家口075000 [2]河北北方学院附属第一医院超声医学科头颈外科

出　　处：《山西医科大学学报》2018年第6期670-673,共4页Journal of Shanxi Medical University

基　　金：河北省张家口市科技局指令性计划(NO 1621031D)

摘　　要：目的探讨甲状腺影像学报告及数据系统(TI-RADS)联合超微血流成像技术(SMI)对甲状腺良恶性结节的鉴别诊断价值。方法选取2016-05~2017-03河北北方学院附属第一医院收治的甲状腺结节患者81例,共92个结节(良性53个,恶性39个),对每个结节依次行二维灰阶超声、CDFI、SMI检查,并按照TI-RADS进行分级,与术后病理或超声引导下细针穿刺抽吸(FNA)对照。比较CDFI与SMI血流分级与分型对甲状腺良恶性结节的鉴别价值;比较单独TI-RADS、TIRADS+CDFI、TI-RADS+SMI对甲状腺结节的诊断价值。结果 (1)SMI对甲状腺结节内血流丰富程度的检出率高于CDFI(P<0.05),两者血流分级对甲状腺良、恶性结节鉴别的差异无统计学意义(P>0.05)。(2)SMI血流分型对结节良恶性鉴别差异有统计学意义(P<0.05),Ⅰ型血流分布模式多以良性结节为主,Ⅳ型、Ⅴ型血流分布模式多以恶性结节为主。(3)与单独应用TI-RADS和TI-RADS+CDFI比较,TI-RADS+SMI技术对甲状腺良恶性结节诊断的敏感度均提高,且差异具有统计学意义(P<0.05)。结论 TI-RADS联合SMI技术能够提高超声对甲状腺结节定性诊断的敏感度;SMI技术能够明显提高甲状腺结节内血流的检出率,清晰地显示出结节内血管的形态、走行等情况,对甲状腺良恶性结节的鉴别具有一定的价值。Objective To investigate the diagnostic value of combination of thyroid imaging reporting and data system（TI-RADS） and SMI in differentiation of malignant and benign of thyroid nodules.Methods A total of 81 patients in the First Hospital of Hebei Northern College from May 2016 to March 2017 were enrolled. All the thyroid nodules（92 nodules,53 benign and 39 malignant nodules） were examined by grey-scale ultrasound, CDFI, SMI, and the nodules were graded by TI-RADS. Then the graded results were compared with results of fine-needle aspiration（FNA） and surgical pathology. The discrimination values of the CDFI and SMI on benign and malignant thyroid nodules were compared, and the diagnostic value of TI-RADS, TI-RADS＋CDFI, and TI-RADS＋SMI on thyroid nodules was also compared.Results ①The SMI showed a higher sensitivity in comparison to CDFI（ P 〈0.05）, and the blood supply had no statistically significant difference between benign and malignant nodules（ P 〉0.05）. ②The types of malignant masses were significantly different from benign masses in SMI images（ P 〈0.05）. Type Ⅰ was more detected in benign lesions and type Ⅳ and Ⅴ were detected more in malignant lesions.③The result revealed that combination of TI-RADS and SMI had a higher sensitivity（ P 〈0.05）.Conclusion Combination of TI-RADS and SMI could improve the sensitivity in diagnosis of thyroid nodules. SMI can clearly show the blood vessels form, direction of thyroid nodules, and has a better detection rate of blood vessels than CDFI, contributing a certain value in differential diagnosis of benign and malignant thyroid nodules.

关 键 词：超微血流成像技术 甲状腺影像学报告及数据系统 甲状腺结节 血管走行形态 

分 类 号：R445[医药卫生—影像医学与核医学]