학술논문
C-TIRADS分类联合剪切波弹性成像鉴别诊断不同大小甲状腺结节的临床价值 / Clinical value of C-TIRADS category combined with shear wave elastography in the differential diagnosis of thyroid nodules with different sizes
Document Type
Academic Journal
Source
临床超声医学杂志 / Journal of Clinical Ultrasound in Medicine. 26(1):54-58
Subject
Language
Chinese
ISSN
1008-6978
Abstract
目的 探讨C-TIRADS分类联合剪切波弹性成像(SWE)鉴别诊断不同大小甲状腺结节良恶性的临床价值.方法 选取经病理确诊的甲状腺结节患者139例(共139个结节),根据结节大小分为最大径≤10 mm组(58个结节)和最大径>10 mm组(81个结节).术前均行常规超声检查并进行C-TIRADS分类;SWE获得结节杨氏模量最大值(Emax)和平均值(Emean),比较两组SWE参数的差异.绘制受试者工作特征(ROC)曲线分析C-TIRADS分类、SWE定量参数单独及联合应用鉴别不同大小甲状腺结节良恶性的诊断效能.结果 C-TIRADS分类诊断最大径≤10 mm组结节良性19个,恶性39个;诊断最大径>10 mm组结节良性50个,恶性31个.最大径≤10 mm组、最大径>10 mm组中良性结节与恶性结节Emax、Emean比较,差异均有统计学意义(均P<0.05).ROC曲线分析显示,C-TIRADS分类联合Emax鉴别最大径≤10 mm结节良恶性的AUC为0.950,均大于二者单独应用(0.866、0.840),差异均有统计学意义(均P<0.05);C-TIRADS分类联合Emax鉴别最大径>10 mm结节良恶性的AUC为0.952,大于Emax(0.777),差异有统计学意义(P<0.05),但与C-TIRADS分类(0.932)比较差异无统计学意义.C-TIRADS 4A类结节中有5个经病理确诊为恶性,其中4个结节的Emax均大于截断值.结论 C-TIRADS分类联合SWE可提高对最大径≤10 mm甲状腺结节良恶性的鉴别诊断效能,SWE可优化C-TIRADS 4A类结节的诊断准确率.
Objective To investigate the clinical value of C-TIRADS category combined with shear wave elastography(SWE)in the differential diagnosis of benign and malignant thyroid nodules with different sizes.Methods Totally 139 patients(139 nodules)confirmed by pathology were selected and divided into the maximum diameter≤10 mm group(58 nodules)and the maximum diameter>10 mm group(81 nodules)according to the size of the nodules.Conventional ultrasound examination and C-TIRADS category were performed before operation.The maximum Young's modulus(Emax)and mean Young's modulus(Emean)of nodules were obtained by SWE.The differences of SWE parameters between the two groups were compared.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of C-TIRAD category,parameters quantitative of SWE alone and their combination in the differential diagnosis of benign and malignant thyroid nodules with different sizes.Results C-TIRADS category diagnosed 19 benign nodules and 39 malignant nodules in the maximum diameter≤10 mm group,while 50 benign and 31 malignant nodules in the maximum diameter>10 mm group.There were significant differences in Emax and Emean of benign and malignant nodules between the maximum diameter≤10 mm group and maximum diameter>10 mm group(all P<0.05).ROC curve analysis showed that the area under the curve of C-TIRADS category combined with Emax in differentiating benign and malignant thyroid nodules with maximum diameter≤10 mm was 0.950,which was higher than that of the two methods applied alone(0.866,0.840),and the differences were statistically significant(both P<0.05).The area under the curve of C-TIRADS category combined with Emax in differentiating benign and malignant thyroid nodules with the maximum diameter>10 mm was 0.952,which was higher than that of Emax(0.777),and the difference was statistically significant(P<0.05),but there was no statistical difference compared with C-TIRADS category(0.932).5 nodules of the C-TIRADS 4A were pathologically confirmed to be malignant,and the Emax value of 4 nodules were higher than the cut-off value.Conclusion C-TIRADS category combined with SWE can improve the differential diagnosis efficiency of benign and malignant thyroid nodules with maximum diameter≤10 mm.SWE can optimize the diagnostic accuracy of C-TIRADS 4A nodules.
Objective To investigate the clinical value of C-TIRADS category combined with shear wave elastography(SWE)in the differential diagnosis of benign and malignant thyroid nodules with different sizes.Methods Totally 139 patients(139 nodules)confirmed by pathology were selected and divided into the maximum diameter≤10 mm group(58 nodules)and the maximum diameter>10 mm group(81 nodules)according to the size of the nodules.Conventional ultrasound examination and C-TIRADS category were performed before operation.The maximum Young's modulus(Emax)and mean Young's modulus(Emean)of nodules were obtained by SWE.The differences of SWE parameters between the two groups were compared.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of C-TIRAD category,parameters quantitative of SWE alone and their combination in the differential diagnosis of benign and malignant thyroid nodules with different sizes.Results C-TIRADS category diagnosed 19 benign nodules and 39 malignant nodules in the maximum diameter≤10 mm group,while 50 benign and 31 malignant nodules in the maximum diameter>10 mm group.There were significant differences in Emax and Emean of benign and malignant nodules between the maximum diameter≤10 mm group and maximum diameter>10 mm group(all P<0.05).ROC curve analysis showed that the area under the curve of C-TIRADS category combined with Emax in differentiating benign and malignant thyroid nodules with maximum diameter≤10 mm was 0.950,which was higher than that of the two methods applied alone(0.866,0.840),and the differences were statistically significant(both P<0.05).The area under the curve of C-TIRADS category combined with Emax in differentiating benign and malignant thyroid nodules with the maximum diameter>10 mm was 0.952,which was higher than that of Emax(0.777),and the difference was statistically significant(P<0.05),but there was no statistical difference compared with C-TIRADS category(0.932).5 nodules of the C-TIRADS 4A were pathologically confirmed to be malignant,and the Emax value of 4 nodules were higher than the cut-off value.Conclusion C-TIRADS category combined with SWE can improve the differential diagnosis efficiency of benign and malignant thyroid nodules with maximum diameter≤10 mm.SWE can optimize the diagnostic accuracy of C-TIRADS 4A nodules.