TI-RADS评分结合VTQ技术鉴别诊断不典型亚急性甲状腺炎与甲状腺乳头状癌的临床价值  

The value of TI-RADS score combined with VTQ technique in the differential diagnosis of atypical subacute thyroiditis and papillary carcinoma of the thyroid

作　　者：田文娟[1] 储立成[1] 黄泽宇[2] TIAN Wenjuan;CHU Licheng;HUANG Zeyu(Department of Ultrasound,the Third People’s Hospital of Changzhou,Changzhou 213001,Jiangsu Province,China;Department of Science and Education,the Third People’s Hospital of Changzhou,Changzhou 213001,Jiangsu Province,China)

机构地区：[1]常州市第三人民医院超声科,江苏常州213001 [2]常州市第三人民医院科教科,江苏常州213001

出　　处：《肿瘤影像学》2021年第4期300-305,共6页Oncoradiology

基　　金：常州市卫生计生委重大科技项目(ZD201714)。

摘　　要：目的:探讨美国放射协会(American College of Radiology,ACR)甲状腺影像报告和数据系统(Thyroid Imaging Reporting and Data System,TI-RADS)评分标准结合声触诊组织定量(virtual touch tissue quantification,VTQ)技术鉴别诊断不典型亚急性甲状腺炎(subacute thyroiditis,SAT)与甲状腺乳头状癌(papillary carcinoma of the thyroid,PTC)的应用价值。方法:选取经超声引导下细针抽吸活组织检查(ultrasound guided-fine needle aspiration biopsy,UG-FNAB)或手术后病理学检查确诊的34例不典型SAT(48个病灶)和29例PTC(34个病灶)患者。按ACR TI-RADS评分标准,根据病灶内部结构、回声、纵横比、边缘、钙化5项超声特征对两组病灶结节逐一赋分,计算总分值,随后应用VTQ技术测量两组病灶内部及病灶周边组织的剪切波速度(shear wave velocity,SWV)值,并进行SWV值及SWV比值(SWV ratio,SWR)的统计学分析。结果:PTC组的TI-RADS总分值(9.53±2.44)高于不典型SAT总分值(5.33±1.59),差异有统计学意义(χ^(2)=8.793,P=0.000),其中病灶纵横比、边缘、局灶性强回声,以及其他超声特征中的淋巴结转移、多灶性在两组间差异均有统计学意义(χ^(2)=12.094、19.887、19.887、11.410、4.257,P均<0.05),而病灶内部结构与回声差异无统计学意义(P=0.415、0.707)。SAT组病灶SWV值(5.53±2.22)m/s高于PTC组SWV值(4.13±1.20)m/s(t=3.632,P=0.001),SAT组病灶SWR(2.58±1.12)高于PTC组SWR(2.14±0.60)(t=2.409,P=0.018)。结论:TI-RADS评分结合VTQ技术有助于提高不典型SAT与PTC鉴别诊断的准确性,值得临床应用推广。Objective:To evaluate the value of American College of Radiology(ACR)Thyroid Imaging Reporting and Data System(TI-RADS)score combined with virtual touch tissue quantification(VTQ)technique in differential diagnosis of atypical subacute thyroiditis(SAT)and papillary carcinoma of the thyroid(PTC).Methods:A total of 34 patients 48 lesions with SAT and 29 patients 34 lesions with PTC confirmed by ultrasound guided-fine needle aspiration biopsy(UG-FNAB)or pathology were selected.According to the internal structure,echo,edge,aspect ratio and calcification of thyroid lesions,the ACR TI-RADS scores were calculated in the two groups.Then VTQ technique was used to measure the shear wave velocity(SWV)and the SWV ratio(SWR)of the lesions to the surrounding tissues.Results:The TI-RADS score of PTC(9.53±2.44)was significantly higher than that of SAT(5.33±1.59)(χ^(2)=8.793,P=0.000).There were significant differences in aspect ratio,edge,focal strong echo,and other ultrasound features of lymph node metastasis,multifocality between the two groups(χ^(2)=12.094,19.887,19.887,11.410,4.257;all P<0.05),but there was no significant difference in internal structure and echo between the two groups(P=0.415,0.707).The SWV in SAT group(5.53±2.22)m/s was significantly higher than that in PTC group(4.13±1.20)m/s(t=3.632,P=0.001).The SWR of SAT group(2.58±1.12)was higher than that of PTC group(2.14±0.60)(t=2.409,P=0.018).Conclusion:TI-RADS score combined with VTQ technique could improve the accuracy of differential diagnosis between atypical SAT and PTC,which is worth popularizing.

关 键 词：亚急性甲状腺炎 甲状腺乳头状癌 超声 鉴别诊断 甲状腺影像报告和数据系统 

分 类 号：R736.1[医药卫生—肿瘤] R445.1[医药卫生—临床医学]