超声造影和弹性成像对TI-RADS4类甲状腺结节的定性诊断的对比研究  

Comparative Study on the Qualitative Diagnosis of Contrast-enhanced Ultrasound and Ultrasonic Elastography of TI-RADS4 Thyroid Nodules

作　　者：范丽青[1] 刘薇[1] 管湘霞[1] 付志勇[1] FAN Liqing;LIU Wei;GUAN Xiangxia(Jiangxi Cancer Hospital,Nanchang,330029)

机构地区：[1]江西省肿瘤医院

出　　处：《实用癌症杂志》2019年第9期1546-1549,共4页The Practical Journal of Cancer

基　　金：江西省卫计委课题(编号:20175417)

摘　　要：目的探讨超声造影(CEUS)和弹性成像(UE)对甲状腺TI-RADS4类结节的良恶性定性诊断价值。方法对79例85枚彩色多普超声诊断为TI-RADS4类的甲状腺结节患者行CEUS和UE检查,参照病理结果进行对比,比较结合UE、CEUS单独诊断及两者联合诊断方法在甲状腺TI-RADS4类结节的诊断中的特异度、灵敏度、准确度及阴性预测值(NPV)、阳性预测值(PPV),并构建ROC曲线,评价各组方法对结节定性诊断价值。结果TI-RADS4类甲状腺结节结合UE、CEUS单独及联合检查诊断结果与病理一致性较好,UE与CEUS诊断的特异度、灵敏度、准确度及NPV、PPV为78.95%、85.11%、82.35%、81.08%、83.33%与86.84%、89.36%、88.24%、86.84%、89.36%,AUC为0.82、0.88,UE与CEUS诊断效能各指标对比,无统计学差异(P>0.05)。两者联合检查的特异度89.47%、灵敏度93.62%、准确度91.76%、NPV91.89%、PPV91.67%,AUC为0.92,均高于CEUS和UE单独检查,但差异无统计学意义(P>0.05)。结论甲状腺TI-RADS4类结节结合CEUS与UE均有助于结节的定性诊断,准确性较高,可以作为TI-RADS4类结节的定性诊断补充。Objective To investigate the value of contrast-enhanced ultrasound(CEUS)and ultrasonic elastography(UE)in the qualitative diagnosis of thyroid TI-RADS 4 nodules.Methods 79 patients with 85 thyroid nodules diagnosed as TI-RADS4 by color Doppler ultrasound were examined by CEUS and UE,the specificity,sensitivity,accuracy and negative prediction(NPV)and positive prediction(PPV)in the diagnosis of thyroid TI-RADS 4 nodules by UE and CEUS alone and their combined diagnostic methods were compared with pathological results,and construct ROC curves,to evaluate the qualitative diagnostic value of each group of methods for nodules.Results The diagnostic results of UE,CEUS and combined examination of TI-RADS4 thyroid nodules were in good agreement with pathology.The specificity,sensitivity,accuracy,NPV and PPV of UE and CEUS were 78.95%,85.11%,82.35%,81.08%,83.33%and 86.84%,89.36%,88.24%,86.84%,89.36%,AUC were 0.82 and 0.88.There was no significant difference in the diagnostic efficacy between UE and CEUS(P>0.05).The specificity,sensitivity,accuracy,NPV,PPV of the combined examination were 89.47%,93.62%,91.76%,91.89%,91.67%,respectively,AUC was 0.92,which were higher than those of CEUS and UE,but there was no statistical difference between UE,CEUS and combined examination(P>0.05).Conclusion TI-RADS4 nodules of thyroid combined with CEUS and UE are helpful in the qualitative diagnosis of nodules,and the accuracy of qualitative diagnosis is good,they can be used as supplements for the qualitative diagnosis of TI-RADS4 thyroid nodules.

关 键 词：甲状腺结节 超声造影 弹性成像 

分 类 号：R736.1[医药卫生—肿瘤]