C-TI-RADS分类联合超声造影在甲状腺良恶性病灶中的鉴别诊断价值  

Differential Diagnostic Value of C-TI-RADS Classification Combined with Contrast-enhanced Ultrasound in Benign and Malignant Thyroid Nodules

作　　者：饶红梅 史俊 陈桂月 戴海鹏 AO Hongmei;SHI Jun;CHEN Guiyue;DAIHaipeng

机构地区：[1]厦门市海沧医院超声影像科,福建厦门361026

出　　处：《中国医学创新》2024年第35期137-140,共4页Medical Innovation of China

摘　　要：目的:探究中国甲状腺影像报告和数据系统(C-TI-RADS)分类联合超声造影在甲状腺良恶性病灶中的鉴别诊断价值。方法:选取2023年1—12月于厦门市海沧医院就诊的60例甲状腺结节患者(154个结节)。所有患者均行C-TI-RADS分类与超声造影检查,以病理检查结果为诊断“金标准”。记录甲状腺结节在C-TI-RADS分类中的分布情况,并分析C-TI-RADS分类、超声造影单独和联合诊断恶性甲状腺结节的价值及与病理检查诊断的一致性。结果:病理检查结果显示,154个结节中良性结节96个,恶性结节58个。C-TI-RADS分类中,3、4A、4B、4C、5类结节的恶性率分别为1.67%、36.36%、71.11%、78.57%、100%。C-TI-RADS分类诊断恶性甲状腺结节的敏感度为77.59%,特异度为83.33%,准确度为81.17%,Kappa值为0.603;超声造影诊断恶性甲状腺结节的敏感度为84.48%、特异度为85.42%、准确度为85.06%,Kappa值为0.687;联合诊断恶性甲状腺结节的敏感度为94.83%、特异度为95.83%、准确度为95.45%,Kappa值为0.904。联合诊断的特异度、准确度均显著高于两种方式单独诊断,敏感度显著高于单独C-TI-RADS分类诊断(P<0.05)。结论:相较于单独使用C-TI-RADS分类或超声造影,两者联合应用可显著提高恶性甲状腺结节的诊断准确性。Objective:To explore the differential diagnostic value of Chinese thyroid imaging reporting and date system(C-TI-RADS)classification combined with contrast-enhanced ultrasound in benign and malignant thyroid nodules.Method:A total of 60 patients with thyroid nodules(154 nodules)admitted to Xiamen Haicang Hospital from January to December 2023 were selected.All patients underwent C-TI-RADS classification and contrast-enhanced ultrasound,and the result of pathological examination was regarded as the"gold standard"for diagnosis.The distribution of thyroid nodules in C-TI-RADS classification was recorded,and the value of C-TIRADS classification and contrast-enhanced ultrasound alone and combined in the diagnosis of malignant thyroid nodules and the consistency with pathological examination were analyzed.Result:Pathological examination showed that 96 of the 154 nodules were benign and 58 were malignant.In the C-TI-RADS classification,the malignant rates of 3,4A,4B,4C and 5 nodules were 1.67%,36.36%,71.11%,78.57%and 100%,respectively.The sensitivity,specificity,accuracy and Kappa value of C-TI-RADS classification in the diagnosis of malignant thyroid nodules were 77.59%,83.33%,81.17%and 0.603,respectively.The sensitivity,specificity,accuracy and Kappa value of contrast-enhanced ultrasound in the diagnosis of malignant thyroid nodules were 84.48%,85.42%,85.06%and 0.687,respectively.The sensitivity,specificity,accuracy and Kappa value of combined diagnosis of malignant thyroid nodules were 94.83%,95.83%,95.45%and 0.904,respectively.The specificity and accuracy of combined diagnosis were significantly higher than those of single diagnosis,and the sensitivity was significantly higher than that of single C-TI-RADS classification diagnosis(P<0.05).Conclusion:Compared with C-TI-RADS classification or contrast-enhanced ultrasound alone,the combined application of both can significantly improve the diagnostic accuracy of malignant thyroid nodules.

关 键 词：甲状腺结节 中国甲状腺影像报告和数据系统 超声造影 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]