彩色多普勒超声与ACR TI-RADS联合诊断甲状腺良恶性结节的价值研究OACSTPCD
Value of Combining Color Doppler Ultrasound and ACR TI-RADS in Differentiating Benign and Malignant Thyroid Nodules
目的:探讨彩色多普勒超声联合ACR TI-RADS分类在甲状腺良恶性结节鉴别诊断中的应用价值.方法:选取自2019年10月至2021年10月间海军安庆医院超声科收治的180例甲状腺结节患者为研究对象.采用ACR TI-RADS分类诊断方法,对二维超声的检查结果进行精准的量化评分.以超声引导下细针穿刺细胞学检查或术后常规病理学检查的病理学结果作为金标准,采用受试者操作特征(ROC)曲线分析两种检测方法单一及联合应用的诊断效能.结果:总计鉴别出甲状腺结节202个,其中,恶性结节占据61个,而良性结节则达到141个.恶性结节的检测灵敏度高达 49.18％(30/61),特异度为 82.27％(116/141),准确度为 72.28％(146/202);ACR TI-RADS分类诊断的灵敏度为49.18％(30/61),特异度为77.30％(109/141),准确度为68.81％(139/202).二者联合检测的灵敏度为55.74％(34/61),特异度为88.65％(125/141),准确度为78.71％(159/202),均显著高于单一检测方法(P＜0.05).彩色多普勒超声诊断不同直径的甲状腺结节的灵敏度、特异度、准确度、阳性预测值和阴性预测值均显著低于联合检测(P＜0.05);彩色多普勒超声检查、ACR TI-RADS分类诊断及二者联合检测的ROC曲线下面积分别为0.813、0.835、0.935,联合检测效能明显大于单一检测(P＜0.05).结论:采用彩色多普勒超声技术与ACR TI-RADS分类法相结合,可以显著提升甲状腺良恶性结节的鉴别精准度,这一方法在临床医学实践中展现出了极高的应用价值,为甲状腺疾病的诊断与治疗提供了有力支持.
Objective:To investigate the application value of color Doppler ultrasonography combined with ACR TI-RADS classification in differentiating benign and malignant thyroid nodules.Methods:A total of 180 patients with thyroid nodules admitted to the Ultrasonography Department of Navy Anqing Hospital from October 2019 to October 2021 were selected as the study objects.The ACR TI-RADS classification diagnosis method was used to accurately quantify the results of two-dimensional ultrasound.The pathological results of ultrasound-guided fine needle aspiration cytology were used as the gold standard,and the diagnostic efficacy of single and combined use of the two methods was analyzed by the receiver operator characteristic(ROC)curve.Results:A total of 202 thyroid nodules were identified,of which 61 were malignant and 141 were benign.The detection sensitivity of malignant nodules was 49.18％(30/61),specificity was 82.27％(116/141)and accuracy was 72.28％(146/202).The sensitivity of ACR TI-RADS alone was 49.18％(30/61),the specificity was 77.30％(109/141)and the accuracy was 68.81％(139/202).The sensitivity,specificity and accuracy of the combined detection were 55.74％(34/61),88.65％(125/141)and 78.71％(159/202),which were significantly higher than that of the single detection method(P＜0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of color Doppler ultrasonography in the diagnosis of thyroid nodules with different diameters were significantly lower than those of combined detection(P＜0.05).The area under ROC curve of color Doppler ultrasonography,ACR TI-RADS classification diagnosis and combined detection were 0.813,0.835 and 0.935,respectively,and the efficiency of combined monitoring was significantly higher than that of single detection(P＜0.05).Conclusion:The combination of color Doppler ultrasound technology and ACR TI-RADS classification can significantly improve the accuracy of the identification of benign and malignant thyroid nodules.This method has shown high application value in clinical medical practice,and provides strong support for the diagnosis and treatment of thyroid diseases.
徐舒;包亚玲;朱洪娟;黄灿灿;张博
海军安庆医院超声科,安徽安庆 246001
临床医学
彩色多普勒超声美国放射学会甲状腺影像报告和数据系统分类诊断甲状腺结节
color Doppler ultrasoundAmerican College of Radiology(ACR)Thyroid Imaging Reporting and Data System(TI-RADS)classification diagnosisthyroid nodule
《影像科学与光化学》 2024 (005)
488-495 / 8
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