应变弹性成像联合C-TIRADS诊断甲状腺结节性质的价值分析  

Value of strain elastography combined with C-TIRADS in the diagnosis of thyroid nodules

作　　者：张亚南 潘泉 朱翔宇 李霞[2] 王俊玲 ZHANGYa-nan;PAN Quan;ZHU Xiang-yu;LI Xia;WANG Jun-ling(Department of Medical Imaging,Weifang Medical University,Weifang 261000,China;Department of Ultrasound Medicine,Qilu Hospital of Shandong University Dezhou Hospital,Dezhou 253000,China)

机构地区：[1]潍坊医学院医学影像学系,山东潍坊261000 [2]山东大学齐鲁医院德州医院超声医学科,山东德州253000

出　　处：《中华肿瘤防治杂志》2022年第24期1741-1745,共5页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的研究应变弹性成像同2020中国甲状腺影像报告和数据系统(C-TIRADS)联合应用预判结节性质的临床价值。方法选取2021-07-01-2021-12-31于山东大学齐鲁医院德州医院进行细针穿刺抽吸细胞学检查并入院手术的74例甲状腺结节患者,共78枚结节,依据C-TIRADS分类标准中的高频灰阶声像图特征对结节进行分级,同时应用弹性成像技术获得靶结节的弹性图,勾勒靶结节(A区)和同深度参照区(B区),自动分析弹性应变率比值(SR:B/A),以最终病理结果为金标准比较2种方法单独及联合应用诊断效能。结果C-TIRADS分类级别与甲状腺结节恶性率呈中度正相关,r=0.575,P<0.001。C-TIRADS分类法曲线下面积(AUC)为0.842,最佳截断值是4B类,诊断灵敏度为94.64%,特异度为59.09%;弹性应变率比值以SR>3.0为最佳截断值,诊断灵敏度为71.42%,特异度为72.72%;应变弹性成像与C-TIRADS联合后,诊断灵敏度为96.42%,特异度为77.27%,相比两者单独诊断时均有所提高,χ2=10.350,P=0.006。结论C-TIRADS与应变弹性成像联合诊断甲状腺结节性质价值更高。Objective To study the clinical value of joint application of strain elastography and 2020 Chinese Thyroid Imaging Reporting and Data System(C-TIRADS)in predicting the nature of nodules.Methods From July 1,2021 to December 31,2021,a total of 78 thyroid nodules were selected from patients with thyroid nodules who underwent fine needle aspiration cytology and surgery in Qilu Hospital of Shandong University Dezhou Hospital.The nodules were classified according to the characteristics of high-frequency gray scale sonogram in C-TIRADS classification standard.At the same time,elastic imaging technology was used to obtain the elastic map of target nodules,outlining the target nodules(area A)and the reference area(area B)at the same depth.The elastic strain rate ratio(SR:B/A)was automatically analyzed,and the final pathological results were used as the gold standard to compare the diagnostic efficacy of the two methods alone and in combination.Results There was a moderate positive correlation between the C-TIRADS classification and the malignant rate of thyroid nodules,r=0.575,P<0.001.The area under the curve(AUC)of C-TIRADS classification method was 0.842,the best cut-off value was Class 4B,the diagnostic sensitivity was 94.64%,and the specificity was 59.09%.The best cutoff value of elastic strain rate ratio was SR>3.0,the diagnostic sensitivity was 71.42%,and the specificity was 72.72%;After the combination of strain elastography and C-TIRADS,the diagnostic sensitivity was 96.42%,and the specificity was 77.27%.which improved compared with both of them when diagnosed alone,χ~2=10.350,P=0.006.Conclusion The combination of C-TIRADS and strain elastography is more valuable in diagnosing the nature of thyroid nodules.

关 键 词：甲状腺结节 中国甲状腺影像报告和数据系统 应变弹性成像 弹性应变率比值 

分 类 号：R736.1[医药卫生—肿瘤]