超声微血流成像技术对C-TIRADS 4类甲状腺实性结节的诊断价值  

The diagnostic value of super microvascular imaging for solid thyroid nodules in C-TIRAPS category 4

作　　者：郑晶晶[1] 齐铮琴[1] 郭帅 付宜永 ZHENG Jing-jing;QI Zheng-qin;GUO Shuai;FU Yi-yong(Department of Ultrasound,Qinhuangdao First Hospital,Qinhuangdao 066099,Hebei,China)

机构地区：[1]秦皇岛市第一医院超声诊断科,河北秦皇岛066099

出　　处：《川北医学院学报》2024年第6期826-829,849,共5页Journal of North Sichuan Medical College

摘　　要：目的:分析超声微血流成像技术(SMI)对C-TIRADS 4类甲状腺实性结节的诊断价值。方法:选取99例C-TIRADS 4类甲状腺实性结节患者为研究对象,患者行常规超声、彩色多普勒血流成像(CDFI)及SMI检查,分析结节的血流Alder分级情况及血流分布特征;以病理结果为对照,评价SMI对甲状腺C-TIRADS 4类甲状腺实性结节良恶性的鉴别诊断价值。结果:恶性组年龄低于良性组(P<0.05);C-TIRADS分类为4A、AB、4C类结节的恶性率分别为22.73%、55.17%、81.25%;良性结节的Adler血流等级以0~1级为主,恶性结节以3级为主;与CDFI相比,SMI对恶性结节的Adler分级0级~1级、2级血流的显示率更低,3级血流的显示率更高(P<0.05)。CDFI显示良性结节血流分型以Ⅰ型~Ⅱ型为主,恶性结节则以Ⅲ型为主;SMI显示良性结节血流分型以Ⅲ型为主,恶性结节以Ⅳ型为主。与CDFI相比,SMI对恶性结节Ⅲ型血流分布显示率更低,对Ⅳ型血流分型的显示率更高(P<0.05)。CDFI、SMI对恶性甲状腺C-TIRADS 4类实性结节均有较好的诊断效能,其ROC曲线下面积(AUC)分别为0.664、0.688,但二者之间诊断效能无统计学差异(Z=0.346,P=0.729)。结论:与CDFI相比,SMI对甲状腺C-TIRADS 4类实性结节血流分布及血流特征的显示更敏感,可用于临床辅助鉴别诊断甲状腺结节的性质。Objective:To analyze the blood flow characteristics of four types of solid thyroid nodules in the Chinese Thyroid Imaging Reporting and Data System(C-TIRADS)4 using superb microvascular imaging(SMI)and investigate the application value of SMI in the diagnosis of benign and malignant thyroid nodules.Methods:A total of 99 patients with C-TIRADS type 4 solid thyroid nodules were selected for routine ultrasound,color Doppler flow imaging(CDFI),and SMI examination to analyze the Alder grading and distribution characteristics of blood flow in the nodules.Evaluate the diagnostic value of SMI in distinguishing benign and malignant thyroid C-TIRADS type 4 solid nodules,using pathological results as a control.Results:Average age of the malignant group was lower than that of the benign group(P<0.05).According to the C-TIRADS,the malignancy rates of 4A,AB and 4C nodules were 22.73%,55.17%,81.25%,respectively.The Adler blood flow grades of benign thyroid nodules were mainly 0~1 grades,while those of malignant nodules were mainly 3 grades.Compared with CDFI,SMI had a lower display rate for Adler blood flow grades of grade 0~1 and grade 2 in malignant nodules,and a higher display rate for Adler blood flow grades of grade 3(P<0.05).CDFI showed that the blood flow classification of benign nodules was mainly typeⅠ~II,while that of malignant nodules was mainly type III.SMI showed that the blood flow classification of benign nodules was mainly type III,while that of malignant nodules was mainly type IV.Compared with CDFI,SMI had a lower display rate of type III blood flow distribution in malignant nodules and a higher display rate of type IV blood flow classification(P<0.05).CDFI and SMI had diagnostic efficacy for hyroid C-TIRADS type 4 solid nodules,with ROC area under the curve(AUC)of 0.664 and 0.688.There was no statistically significant difference in diagnostic efficacy between CDFI and SMI(Z=0.346,P=0.729).Conclusion:Compared with CDFI,SMI is more sensitive in displaying the blood flow distribution and characteristics of thy

关 键 词：甲状腺结节 甲状腺实质 超声微血流成像技术 血流特征 鉴别诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]