TI-RADS 4类甲状腺结节的超声造影表现  

Contrast-enhanced ultrasound imaging of thyroid nodules in thyroid imaging reporting and data system category 4

作　　者：陈圣[1] 唐力[1] 吴松松[1] 李建卫[1] 林宁[1] CHEN Sheng;TANG Li;WU Songsong;LI Jianwei;LIN Ning(Department of Ultrasonography,Fujian Provincial Hospital of Fujian Medical University,Fuzhou 350001,China)

机构地区：[1]福建医科大学省立临床学院超声科,福建福州350001

出　　处：《中国现代医生》2020年第8期123-127,共5页China Modern Doctor

摘　　要：目的探讨TI-RADS 4类甲状腺结节的超声造影表现。方法对我院2016年8月~2018年4月诊断为TI-RADS 4类的216个甲状腺结节行超声造影检查,手术病理结果显示56个良性结节,160个恶性结节。分析良恶性结节在TI-RADS 4类中的具体分布情况,计算超声造影诊断的敏感性、特异性、准确性、阳性预测值(PPV)及阴性预测值(NPV),绘制ROC曲线,计算曲线下面积。结果本研究中TI-RADS 4类的甲状腺结节的恶性率高于参考值。CEUS诊断TI-RADS4a、4b及4c中各自的敏感性、特异性、PPV、NPV、准确率分别为100.0%、50.0%、50.0%、100.0%、66.6%;100.0%、25.0%、76.9%、100.0%、78.6%;89.3%、16.7%、83.3%、25.0%、76.5%。CEUS诊断TIRADS 4a、4b及4c各自的AUC分别为0.750、0.625及0.530。结论超声造影对TI-RADS 4类甲状腺结节的整体诊断效能一般,对TI-RADS 4a甲状腺结节的诊断效能尚可。Objective To investigate the contrast-enhanced ultrasound(CEUS)imaging of thyroid nodules in thyroid imaging reporting and data system(TI-RADS)category 4.Methods From August 2016 to April 2018,CEUS was performed for 216 thyroid nodules which had been diagnosed as TI-RADS category 4.Post-operative pathology revealed56 benign nodules and 160 malignant ones.Their distribution in TI-RADS category 4 nodules was analyzed.The sensitivity,specificity,accuracy,positive predictive value(PPV)and negative predictive value(NPV)were calculated.The receiver-operating characteristic(ROC)curve was drawn to estimate the area under ROC curve(AUC).Results In this study,the malignancy rate of thyroid nodules in TI-RADS 4 was higher than the reference value.In TI-RADS 4 a nodules,the sensitivity,specificity,PPV,NPV and accuracy of CEUS in differentiating malignant nodules from benign ones were 100.0%,50.0%,50.0%,100.0%and 66.6%.In TI-RADS 4 b nodules,its sensitivity,specificity,PPV,NPV and accuracy were 100.0%,25.0%,76.9%,100.0%and 78.6%,and 89.3%,16.7%,83.3%,25.0%and 76.5%in TI-RADS4 c nodules.The AUCs for CEUS diagnosis of TI-RADS 4 a,4 b and 4 c were 0.750,0.625 and 0.530,respectively.Conclusion The overall diagnostic efficacy of CEUS in TI-RADS 4 thyroid nodules was merely below expectations,with the favorable diagnostic efficacy in TI-RADS 4 a nodules.

关 键 词：TI-RADS 4类 甲状腺结节 超声造影 诊断效能 

分 类 号：R581[医药卫生—内分泌] R445.1[医药卫生—内科学]