广西医学
廣西醫學
엄서의학
Guangxi Medical Journal
2015年
8期
1079-1081,1084
,共4页
邓瑶瑶%何云%杨红%方芹%褚桐苇%郭莉娟
鄧瑤瑤%何雲%楊紅%方芹%褚桐葦%郭莉娟
산요요%하운%양홍%방근%저동위%곽리연
甲状腺结节%甲状腺影像学报告及数据系统%超声造影%鉴别诊断
甲狀腺結節%甲狀腺影像學報告及數據繫統%超聲造影%鑒彆診斷
갑상선결절%갑상선영상학보고급수거계통%초성조영%감별진단
Thyroid nodule%Thyroid imaging reporting and data system%Contrast enhanced ultrasound%Differential diagnosis
目的 探讨甲状腺影像学报告及数据系统( TI-RADS)分级联合超声造影( CEUS)鉴别甲状腺良、恶性结节的价值. 方法 选取91例甲状腺结节患者(共127个结节) ,分别行常规超声及CEUS检查,所有病灶依据二维超声特征进行TI-RADS分级,并经手术病理证实,以病理检查结果为金标准,评估TI-RADS分级、CEUS及二者联合诊断甲状腺癌的价值.结果 甲状腺恶性结节的CEUS增强模式主要表现为早期低增强、不均匀增强、周边无环状增强,以此为甲状腺恶性结节的诊断标准,其灵敏度、特异度及符合率分别为73.08%(19/26)、80.20%(81/101)、78.74%(100/127);73.08%(19/26)、75.25%(76/101)、74.80%(95/127);96.15%(25/26)、32.67%(33/101)、45.67%(58/127). 以TI-RADS分级5级判定为恶性,其灵敏度、特异度及符合率分别为46.15%(12/26)、99.00%(100/101)、88.19%(112/127);TI-RADS分级联合CEUS诊断甲状腺恶性结节的灵敏度、特异度及符合率分别为80.76%(21/26)、96.04%(97/101)、92.91%(118/127). TI-RADS分级联合CEUS诊断对甲状腺恶性结节的准确性明显高于TI-RADS分级或CEUS单独诊断( P<0.05). 结论 TI-RADS分级可对甲状腺病灶进行初步规范化恶性风险判断,利用CEUS可进一步提高结节的良恶性鉴别诊断能力,二者联合可提高甲状腺结节的术前诊断能力.
目的 探討甲狀腺影像學報告及數據繫統( TI-RADS)分級聯閤超聲造影( CEUS)鑒彆甲狀腺良、噁性結節的價值. 方法 選取91例甲狀腺結節患者(共127箇結節) ,分彆行常規超聲及CEUS檢查,所有病竈依據二維超聲特徵進行TI-RADS分級,併經手術病理證實,以病理檢查結果為金標準,評估TI-RADS分級、CEUS及二者聯閤診斷甲狀腺癌的價值.結果 甲狀腺噁性結節的CEUS增彊模式主要錶現為早期低增彊、不均勻增彊、週邊無環狀增彊,以此為甲狀腺噁性結節的診斷標準,其靈敏度、特異度及符閤率分彆為73.08%(19/26)、80.20%(81/101)、78.74%(100/127);73.08%(19/26)、75.25%(76/101)、74.80%(95/127);96.15%(25/26)、32.67%(33/101)、45.67%(58/127). 以TI-RADS分級5級判定為噁性,其靈敏度、特異度及符閤率分彆為46.15%(12/26)、99.00%(100/101)、88.19%(112/127);TI-RADS分級聯閤CEUS診斷甲狀腺噁性結節的靈敏度、特異度及符閤率分彆為80.76%(21/26)、96.04%(97/101)、92.91%(118/127). TI-RADS分級聯閤CEUS診斷對甲狀腺噁性結節的準確性明顯高于TI-RADS分級或CEUS單獨診斷( P<0.05). 結論 TI-RADS分級可對甲狀腺病竈進行初步規範化噁性風險判斷,利用CEUS可進一步提高結節的良噁性鑒彆診斷能力,二者聯閤可提高甲狀腺結節的術前診斷能力.
목적 탐토갑상선영상학보고급수거계통( TI-RADS)분급연합초성조영( CEUS)감별갑상선량、악성결절적개치. 방법 선취91례갑상선결절환자(공127개결절) ,분별행상규초성급CEUS검사,소유병조의거이유초성특정진행TI-RADS분급,병경수술병리증실,이병리검사결과위금표준,평고TI-RADS분급、CEUS급이자연합진단갑상선암적개치.결과 갑상선악성결절적CEUS증강모식주요표현위조기저증강、불균균증강、주변무배상증강,이차위갑상선악성결절적진단표준,기령민도、특이도급부합솔분별위73.08%(19/26)、80.20%(81/101)、78.74%(100/127);73.08%(19/26)、75.25%(76/101)、74.80%(95/127);96.15%(25/26)、32.67%(33/101)、45.67%(58/127). 이TI-RADS분급5급판정위악성,기령민도、특이도급부합솔분별위46.15%(12/26)、99.00%(100/101)、88.19%(112/127);TI-RADS분급연합CEUS진단갑상선악성결절적령민도、특이도급부합솔분별위80.76%(21/26)、96.04%(97/101)、92.91%(118/127). TI-RADS분급연합CEUS진단대갑상선악성결절적준학성명현고우TI-RADS분급혹CEUS단독진단( P<0.05). 결론 TI-RADS분급가대갑상선병조진행초보규범화악성풍험판단,이용CEUS가진일보제고결절적량악성감별진단능력,이자연합가제고갑상선결절적술전진단능력.
Objective To investigate the diagnostic value of thyroid imaging reporting and data system( TI-RADS) combined with contrast enhanced ultrasound( CEUS) in differentiating benign and malignant thyroid nodules.Methods Ninety-one patients with thyroid nodule involving 127 nodules were examined by conventional ultrasound and CEUS respectively.All of the nodules were graded by TI-RADS based on their two-dimensional ultrasound features, and then were confirmed by their pathologic findings after operation.The pathologic findings were taken as golden standard to assess the values of TI-RADS,CEUS and their combination in the diagnosis of thyroid cancer.Results Most of the images of CEUS enhancement pattern for malignant thyroid nodules showed early hypoenhancement,heterogeneous enhancement and no surrounding ring enhancement.Based on these features as the diagnostic standard of malignant thyroid nodules, the sensitivity,specificity and coincidence rate for the diagnosis of early hypoenhancement were 73.08%(19/26),80.20%(81/101) and 78.74%(100/127),respectively,of heterogeneous enhancement were 73.08%(19/26),75.25%(76/101) and 74.80%(95/127),respectively,and of no surrounding ring enhancement were 96.15%(25/26),32.67%(33/101) and 45.67%(58/127),respectively.Based on TI-RADS Grade 5 as malignants,the sensitivity,specificity and coincidence rate of TI-RADS for the diagnosis of malignant thyroid nodules were 46.15%(12/26), 99.00%(100/101) and 88.19%(112/127),respectively;of TI-RADS combined with CEUS were 80.76%(21/26),96.04%(97/101) and 92.91%(118/127),respectively.TI-RADS combined with CEUS had a significantly higher accuracy in the diagnosis of malignant thyroid nodules compared with TI-RADS or CEUS alone(P<0.05).Conclusion TI-RADS might give a preliminary and standard risk judgment on malignant thyroid lesions,the use of CEUS might further improve the efficiency in the differential diagnosis of benign and malignant nodules,and the combination of TI-RADS and CEUS might improve the efficiency in the preoperative diagnosis of thyroid nodules.
