弹性分级与弹性应变率比值在甲状腺TI-RADS分类中的应用
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摘要
目的探讨结合超声弹性分级与弹性应变率比值的改良TI-RADS分类对甲状腺结节良恶性的诊断价值。方法对285个甲状腺结节行常规超声检查,依据常规TI-RADS标准判断良恶性。对结节进行弹性分级,检测弹性应变率比值,对TI-RADS分类进行调整,评价常规TI-RADS与改良TI-RADS对结节良恶性鉴别的诊断价值。结果常规TI-RADS与改良TI-RADS的准确度、灵敏度、特异度、阴性及阳性预测值分别为83.86%、82.75%、84.62%、87.73%、78.69%与92.98%、92.24%、93.49%、94.61%、90.68%,ROC曲线下面积(AUC)分别为0.837±0.026、0.929±0.018,差异有统计学意义。结论改良TI-RADS诊断标准提高了甲状腺良恶性结节诊断准确度,为临床提供了更好的诊断手段,值得推广应用。
Objective To investigate the diagnostic value of ultrasonic elastic strain ratio and ultrasonic elastography(UE)grade combined with TI-RADS in diagnosis of thyroid nodules.Methods Two-dimensional ultrasound and elastic strain ratio elastic strain ratio elastography examination were both performed in 285 patients with thyroid nodules.According of elastic strain ratio,the conventional TI-RADS is adjusted to the modified TI-RADS.Receiver operating characteristic(ROC)curves were used to assess the diagnostic value of the two methods.The sensitivity,specificity and accuracy of this two methods were compared.Results The area under the ROC curve(Az)of the two methods were 0.837(conventional TI-RADS)and 0.929(improved TI-RADS),respectively.The difference between them was statistically significant.The accuracy,sensitivity,specificity,positive and negative predictive value of the two methods were 83.86%,82.75%,84.62%,87.73%,78.69% and 92.98%,92.24%,93.49%,94.61%,90.68%,respectively.Conclusions Diagnostic value of UE was better than TI-RADS.The combination of TI-RADS and UE could improve the differentiation of thyroid nodules.The improved TI-RADS provide a better diagnostic means for clinical application,which is worthy of popularization and application.
Objective To investigate the diagnostic value of ultrasonic elastic strain ratio and ultrasonic elastography(UE)grade combined with TI-RADS in diagnosis of thyroid nodules.Methods Two-dimensional ultrasound and elastic strain ratio elastic strain ratio elastography examination were both performed in 285 patients with thyroid nodules.According of elastic strain ratio,the conventional TI-RADS is adjusted to the modified TI-RADS.Receiver operating characteristic(ROC)curves were used to assess the diagnostic value of the two methods.The sensitivity,specificity and accuracy of this two methods were compared.Results The area under the ROC curve(Az)of the two methods were 0.837(conventional TI-RADS)and 0.929(improved TI-RADS),respectively.The difference between them was statistically significant.The accuracy,sensitivity,specificity,positive and negative predictive value of the two methods were 83.86%,82.75%,84.62%,87.73%,78.69% and 92.98%,92.24%,93.49%,94.61%,90.68%,respectively.Conclusions Diagnostic value of UE was better than TI-RADS.The combination of TI-RADS and UE could improve the differentiation of thyroid nodules.The improved TI-RADS provide a better diagnostic means for clinical application,which is worthy of popularization and application.
引文
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[6]张正顺,高翠霞,方耀武.TI-RADS分级在诊断甲状腺结节良恶性方面的应用研究[J].中国超声医学杂志,2013,29(8):751-754.
[7]刘芳,肖萤,谢萍,等.超声弹性成像应变率值与灰阶超声诊断甲状腺疾病的对照研究[J].中国超声医学杂志,2010,26(8):692-694.
[2]刘利平,张立,刘静静,等.TI-RADS分级结合弹性成像对甲状腺结节鉴别诊断及不同医师一致性研究[J].中国超声医学杂志,2015,31(6):490-493.
[3]燕山,詹维伟,周建桥.甲状腺与甲状旁腺超声影像学[M].北京:科学技术文献出版社,2009:240-252.
[4]宋建明,刘远飞,曾晓英,等.彩超联合组织弹性成像在甲状腺结节诊断中的对比研究[J].中国超声医学杂志,2015,31(8):673-675.
[5]黄巧燕,丰波,文妙云,等.超声弹性成像对甲状腺结节TIRADS分类的影响[J].中国超声医学杂志,2015,31(10):865-867.
[6]张正顺,高翠霞,方耀武.TI-RADS分级在诊断甲状腺结节良恶性方面的应用研究[J].中国超声医学杂志,2013,29(8):751-754.
[7]刘芳,肖萤,谢萍,等.超声弹性成像应变率值与灰阶超声诊断甲状腺疾病的对照研究[J].中国超声医学杂志,2010,26(8):692-694.