C-TIRADS联合STE对C-TIRADS 4类结节良恶性的诊断价值  

Diagnostic value of C-TIRADS combined with STE in distinguish benign and malignant of thyroid nodules with C-TIRADS type 4

作　　者：彭炜 孙碧云 王鑫金 李鑫 江峰 Peng Wei;Sun Biyun;Wang Xinjin;Li Xin;Jiang Feng(Department of Ultrasonic Medicine,Yijishan Hospital(the First Affiliated Hospital of Wannan Medical College)Wuhu,Anhui 241000,China)

机构地区：[1]皖南医学院第一附属医院弋矶山医院超声医学科,安徽芜湖241000

出　　处：《齐齐哈尔医学院学报》2024年第4期358-362,共5页Journal of Qiqihar Medical University

摘　　要：目的 分析C-TIRADS分类联合声触弹性成像(sound touch elastography,STE)在C-TIRADS 4类结节良恶性中的诊断价值。方法 回顾性分析2023年2—8月在本院行甲状腺细针穿刺活检(FNA)或手术的302例患者的临床资料(共309个C-TIRADS 4类结节)。用STE、C-TIRADS分类、C-TIRADS分类联合STE中“壳”参数(即校正C-TIRADS分类)分别对结节进行良恶性鉴别,以细胞或者术后病理诊断结果为准,采用Kappa一致性检验和绘制受试者工作特征曲线(receiver operating characteristic,ROC)并计算曲线下面积(area under curve,AUC),比较STE、C-TIRADS分类、校正C-TIRADS对C-TIRADS 4类结节良恶性的诊断效能。结果 病理结果显示,309个结节中93个为良性结节,216个为恶性结节。病理结果和C-TIRADS分类诊断结果的Kappa系数为0.488(P<0.05);病理结果和STE诊断结果的Kappa系数为0.479(P<0.05);病理结果和校正C-TIRADS诊断结果的Kappa系数为0.704(P<0.05)。ROC曲线结果显示,C-TIRADS分类诊断的AUC为0.709,敏感度、特异度及准确率分别为97.70%、44.10%和81.55%;STE诊断AUC为0.769,敏感度、特异度及准确率分别为73.10%、80.60%和75.51%;校正C-TIRADS分类诊断AUC为0.848,敏感度、特异度及准确率分别为92.10%、77.40%和72.64%。结论 C-TIRADS分类联合STE较单独使用STE、C-TIRADS分类在C-TIRADS 4类结节性质有更好的诊断价值,值得临床推广。Objective To analyze the diagnostic value of C-TIRADS classification combined with sound touch elastography(STE) in distinguish benign and malignant C-TIRADS 4 nodules.Methods The clinical data of 302 patients(309 C-TIRADS 4 nodules) who underwent thyroid fine needle aspiration biopsy(FNA) or surgery in Yijishan hospital of Wannan Medical College from February 2023 to August 2023 were retrospectively analyzed.Benign and malignant nodules were identified by STE,C-TIRADS classification,and C-TIRADS classification combined with “shell” parameters in STE(corrected C-TIRADS classification).Based on the results of cell or postoperative pathological diagnosis,Kappa consistency test and receiver operating characteristic(ROC) curve were carried out,the area under curve(AUC) was calculated.The diagnostic efficacy of STE,C-TIRADS classification and corrected C-TIRADS in C-TIRADS 4 nodules was compared.Results According to the results of pathology,among the 309 nodules,93 were benign nodules and 216 were malignant nodules.The Kappa coefficient between pathological results and C-TIRADS classification results was 0.488(P<0.05);The Kappa coefficient between pathological results and STE diagnosis was 0.479(P<0.05);The Kappa coefficient between pathological results and corrected C-TIRADS results was 0.704(P<0.05).ROC curve results showed that the AUC of C-TIRADS classification diagnosis was 0.713,and the sensitivity,specificity and accuracy were 97.70%,44.10% and 81.55%,respectively.The AUC of STE diagnosis was 0.709,and the sensitivity,specificity and accuracy were 73.10%,80.60% and 75.51%,respectively.The AUC of corrected C-TIRADS classification was 0.848,and the sensitivity,specificity and accuracy were 92.10%,77.40% and 72.64%,respectively.Conclusions C-TIRADS classification combined with STE achieves better diagnostic value than STE and C-TIRADS classification alone in C-TIRADS category 4 nodule nature,which is worthy of clinical promotion.

关 键 词：声触弹性成像 杨氏模量值 甲状腺结节 超声 C-TIRADS 

分 类 号：R581[医药卫生—内分泌]