二维超声TI-RADS分类联合超声造影在诊断甲状腺癌中的应用

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英文篇名：Two-dimensional Ultrasound TI-RADS Classification Combined with Contrast-enhanced Ultrasound in Thyroid Cancer Diagnosis 作者：吴晓安 ; 刘丽萍 英文作者：WU Xiaoan;LIU Liping;Department of Ultrasound, the First Hospital Affiliated to Chongqing Medical University; 关键词：甲状腺肿瘤 ; 超声检查 ; 造影剂 ; 甲状腺影像学报告及数据系统 英文关键词：Thyroid neoplasms;;Ultrasonography;;Contrast media;;Thyroid imaging reporting and data system 中文刊名：ZYYZ 英文刊名：Chinese Journal of Medical Imaging 机构：重庆医科大学附属第一医院超声科; 出版日期：2019-02-25 出版单位：中国医学影像学杂志 年：2019 期：v.27;No.189 基金：重庆市卫生局面上项目(2011-2-100) 语种：中文; 页：ZYYZ201902013 页数：4 CN：02 ISSN：11-3154/R 分类号：57-60

摘要

目的探讨二维超声甲状腺影像报告和数据系统(TI-RADS)分级联合超声造影(CEUS)对甲状腺癌的诊断价值。资料与方法回顾性分析300例甲状腺结节患者(共419个结节)的二维超声及CEUS资料,观察甲状腺癌二维超声、CEUS征象,并以手术病理结果为"金标准",比较二维超声TI-RADS分类、CEUS单一及其联合检查甲状腺癌的诊断效能。结果 419个甲状腺结节经手术病理证实恶性结节135个,其中乳头状癌126个。二维超声显示甲状腺恶性结节142个,表现出低回声119个,均形态不规则、内部回声不均;CEUS检出甲状腺恶性结节153个,其中不均匀低强化120个。TI-RADS分级联合CEUS诊断甲状腺癌的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为93.33%、92.96%、93.08%、86.30%、96.70%,均显著高于TI-RADS分级的74.07%、85.21%、81.62%、70.42%、87.36%以及CEUS检查的85.19%、86.62%、86.16%、75.16%、92.48%,差异均有统计学意义(P均<0.05)。结论与二维超声TI-RADS分类、CEUS单一检查相比,两者联合检查诊断甲状腺癌具有明显优势。
        Purpose To explore the diagnostic value of two-dimensional thyroid imaging reporting and data system(TI-RADS classification combined with contrast-enhanced ultrasound(CEUS) in thyroid cancer. Materials and Methods The two-dimensional ultrasound and CEUS imaging data of 300 patients with thyroid nodules(in total 419 nodules) were retrospectively analyzed. Twodimensional ultrasound and CEUS signs of thyroid cancer were observed and with surgical pathological results as golden standards, twodimensional ultrasound TI-RADS classification, CEUS single and diagnostic efficacy of thyroid cancer with combined examination were compared. Results Among the 419 thyroid nodules, 135 nodules were confirmed by surgery and pathology malignant, including 126 papillary carcinomas. Two-dimensional ultrasound showed 142 malignant thyroid nodules and 119 nodules showed hypoechoic echoes.All nodules were irregular in morphology and inhomogeneous in internal echo. 153 malignant thyroid nodules were detected through CEUS, including 120 nodules with inhomogeneous low enhancement. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value of TI-RADS classification combined CEUS in thyroid cancer diagnosis were 93.33%, 92.96%, 93.08%, 86.30%and 96.70%, respectively; which were significantly higher than the 74.07%, 85.21%, 81.62%, 70.42%, 87.36% of TI-RADS classification and 85.19%, 86.62%, 86.16%, 75.16% and 92.48% examined by CEUS. The difference was of statistical significance(all P<0.05).Conclusion Compared with two-dimensional ultrasound TI-RADS classification and CEUS single examination, combination of the two has obvious advantages in thyroid cancer diagnosis.

引文

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