甲状腺结节超声造影征象及诊断一致性评估  

The evaluation of the interobserver variability of contrast enhanced ultrasound signs and diagnosis for thyroid nodules

作　　者：傅强 熊颖 宋可馨 刘昊 闫妍 林霖 FU Qiang;XIONG Ying;SONG Kexin;LIU Hao;YAN Yan;LIN Lin(Department of Ultrasound,Civil Aviation General Hospital,Beijing 100123,China)

机构地区：[1]民航总医院超声医学科,北京100123

出　　处：《医学影像学杂志》2025年第2期29-32,38,共5页Journal of Medical Imaging

基　　金：民航总医院科研课题项目(编号:201915)。

摘　　要：目的探讨超声造影(CEUS)评分法鉴别诊断甲状腺良恶性结节观察者间一致性。方法选取我院行手术切除或细针穿刺抽吸活检(FNA)的116例患者的121个甲状腺结节CEUS资料。应用单因素Logistic回归分析不同CEUS征象诊断甲状腺结节价值。绘制受试者工作特征(ROC)曲线,评估CEUS评分法诊断甲状腺结节价值。应用Kappa检验评估超声医师对于不同CEUS征象和超声诊断结果一致性。结果慢进、向心性增强、低增强、不均匀增强提示恶性结节,结节周围规则环状增强提示良性结节。规则环状增强Kappa值为0.813,慢进、向心性增强、低增强、不均匀增强Kappa值为0.633~0.665。应用CEUS评分法诊断甲状腺结节ROC曲线下面积(AUC)为0.854。CEUS诊断甲状腺结节Kappa值为0.785。结论规则环状增强评估一致性极好,CEUS诊断甲状腺结节一致性较好。Objective To investigate the interobserver variability of contrastenhanced ultrasound(CEUS)scoring method in the differential diagnosis of benign and malignant thyroid nodules.Methods A retrospective analysis of CEUS examination was conducted on 121 thyroid nodules from 116 patients who underwent surgical resection or fine needle aspiration(FNA)biopsy in our hospital.The diagnostic value of various CEUS signs was evaluated using univariate logistic regression analysis.Receiver operator characteristic(ROC)curve was used to assess the diagnostic performance of CEUS scoring method.Interobserver variability of various CEUS signs and the diagnosis of CEUS were determined using Kappa statistics.Results Logistic regression analysis of CEUS revealed that slow enhancement,centrality enhancement,hypo-enhancement,and inhomogeneous enhancement were indicative of malignant nodule,while,regular rim-like enhancementaround nodule suggested benign nodule.The Kappa value for rim-like enhancement was excellent at 0.813.The Kappa values for slow enhancement,centrality enhancement,hypoenhancement,and inhomogeneous enhancement ranged from 0.633 to 0.665.The area under the ROC of CEUS scoring method was 0.854.The Kappa value for CEUS diagnosis was 0.785.Conclusions The regular rim-like enhancement showed excellent consistency,and there was good interobserver agreement for diagnosing thyroid nodules with CEUS.

关 键 词：甲状腺结节 超声检查 超声造影 诊断 

分 类 号：R736.1[医药卫生—肿瘤] R445.1[医药卫生—临床医学]