SMART 3D-SMI在甲状腺TI-RADS 4类结节良恶性鉴别诊断中的应用  

Application of SMART 3D-SMI in the Differential Diagnosis of Benign and Malignant in TI-RADS 4 Thyroid Nodules

作　　者：李朝喜[1] 温德惠[1] 刘伟亮[1] 陆海永 LI Chaoxi;WEN Dehui;LIU Weiliang;LU Haiyong(The First Affiliated Hospital of Heibei North University,Zhangjiakou 075000,Hebei,P.R.China)

机构地区：[1]河北北方学院附属第一医院,河北张家口075000

出　　处：《影像科学与光化学》2022年第3期510-514,共5页Imaging Science and Photochemistry

摘　　要：探讨超微血管三维立体超声成像(SMART 3D-SMI)在甲状腺影像学报告及数据系统(TI-RADS)4类结节良恶性鉴别诊断。选取120例(128个结节)TI-RADS 4类结节患者,分析CDFI、2D-SMI、3D-SMI对TI-RADS 4类结节良恶性的诊断效能。病理确诊良性84个,恶性44个。TI-RADS 4a级87个,4b级30个,4c级11个,准确率为67.97%。与CDFI比,2D-SMI、3D-SMI的血流分级较高;与CDFI比,2D-SMI、3D-SMI检出3级血流较多;2D-SMI与3D-SMI的Adler分级比较,差异无统计意义(P>0.05)。良性结节在CDFI、2D-SMI、3D-SMI的血流分布模式差异无统计意义(P>0.05),与CDFI比,恶性结节在2D-SMI与3D-SMI模式下的Ⅲ型显示率较高(P<0.05)。TI-RADS分别联合CDFI、2D-SMI、3D-SMI鉴别诊断甲状腺结节良恶性,三者比较,TI-RADS+3D-SMI的敏感性、准确度及阴性预测值更高(P<0.05),诊断特异度、阳性预测值差异无统计意义(P>0.05)。SMART 3D-SMI能准确评估甲状腺TI-RADS 4类结节的微血管空间分布和模式。This study investigated the application value of 3-dimensional ultrasound imaging(smart 3D-SMI)in the differential diagnosis of benign and malignant in TI-RADS 4 thyroid nodules.120 cases of patients(128 nodules)with TI-RADS type 4 nodules were selected and analyzed the diagnostic efficacy of CDFI,2D-SMI and 3D-SMI for benign and malignant of TI-RADS type 4 nodules.Pathologically confirmed 84 cases benign and 44 cases malignant.TI-RADS had 87 grades 4a,30 grades 4b and 11 grades 4c,with an accuracy rate of 67.97%.Compared with CDFI,2D-SMI and 3D-SMI had higher blood flow grades,and detected more grade 3 blood flow.There was no statistically significant difference between 2D-SMI and 3D-SMI grades(P>0.05).There was no significant difference in the blood flow distribution pattern of benign nodules in CDFI,2D-SMI and 3D-SMI(P>0.05).Compared with CDFI,malignant nodules showed more typeⅢin 2D-SMI and 3D-SMI modes(P<0.05).TI-RADS combined with CDFI,2D-SMI and 3D-SMI respectively in the differential diagnosis of benign and malignant thyroid nodules,compared of the three methods,TI-RADS+3D-SMI had higher sensitivity,accuracy and negative predictive value(P<0.05),and had no significant difference in diagnostic specificity and positive predictive value(P<0.05).SMART 3D-SMI can accurately assess the microvascular spatial distribution and pattern of thyroid TI-RADS 4 nodules.

关 键 词：甲状腺结节 超微血管三维立体超声成像 甲状腺影像学报告及数据系统 鉴别诊断 

分 类 号：R581[医药卫生—内分泌]