摘要
Abstract
Objective:To evaluate the diagnostic performance of multimodal ultrasound combined with spectral CT analysis,integrating conventional ultrasound and virtual touch tissue imaging quantification(VTIQ)shear wave elastography(SWE),for differentiating thyroid imaging reporting and data system(TI-RADS)4a and 4b nodules.Methods:This study analyzed 82 thyroid nodules(41 TI-RADS 4a and 41 4b)from 75 patients.Pathological results revealed 50 benign and 32 malignant nodules.All lesions underwent conventional ultrasound followed by VTIQ measurements,where transverse shear wave velocity(SWV)was measured 5-7 times in each nodule and adjacent thyroid parenchyma at the same plane.Three parameters were obtained,mean nodule SWV(SWV1),mean parenchymal SWV(SWV2),and SWV1/SWV2 ratio.Contrast-enhanced spectral CT parameters including iodine concentration(IC),normalized iodine concentration(NIC),and spectral curve slope were acquired during arterial and venous phases.Multivariate regression identified independent risk factors.Using histopathology and/or fine needle aspiration as reference standards,diagnostic performance was compared between multimodal ultrasound alone and combined with spectral CT.Results:Independent risk factors for malignancy included acoustic halo,posterior attenuation,SWV1/SWV2 ratio,arterial-phase IC,and arterial-phase NIC(all P<0.05).The AUCs of conventional ultrasound binary classification,multimodal ultrasound,multimodal ultrasound combined with spectral CT were 0.696,0.773,0.891,the sensitivities of these methods were 59.38%,71.88%,78.13%,the specificities were 78.00%,72.00%,90.00%,the positive predictive values were 63.33%,62.16%,83.33%,the negative predictive values were 75.00%,80.00%,86.54%,respectively.Conclusions:The combination of multimodal ultrasound and spectral CT significantly enhances diagnostic accuracy.For TI-RADS 4a nodules,this integrated approach may reduce unnecessary fine needle aspiration procedures while providing comprehensive imaging evidence for clinical decision-making.关键词
甲状腺影像报告与数据系统/超声检查/弹性成像技术/体层摄影术,X线计算机/能谱成像/细针抽吸活检Key words
Thyroid imaging reporting and data system/Ultrasonography/Elasticity imaging techniques/Tomography,X-ray computed/Spectral imaging/Fine needle aspiration
