局解手术学杂志2026，Vol.35Issue(5)：380-384,5.DOI:10.11659/jjssx.09E025012
二维超声联合剪切波弹性成像对TI-RADS分级3～5级甲状腺结节的诊断价值
Diagnostic value of two-dimensional ultrasound combined with shear wave elastography for thyroid nodules with TI-RADS categories 3 to 5
摘要
Abstract
Objective To explore the diagnostic value of two-dimensional ultrasound combined with shear wave elastography(SWE)for thyroid nodules with thyroid imaging reporting and data system(TI-RADS)categories 3 to 5.Methods A retrospective analysis was conducted on the clinical data of 248 patients with TI-RADS categories 3 to 5 thyroid nodules treated in our hospital from January 2023 to January 2025.According to the pathological diagnosis results,the patients were divided into the benign group(n=75)and the malignant group(n=173).The two-dimensional ultrasound features,and the maximum Young's modulus(Emax)and average Young's modulus(Emean)of suspicious nodules were recorded in both groups.The diagnostic performance of two-dimensional ultrasound and SWE for benign and malignant thyroid nodules and their consistency with pathological diagnosis were analyzed.The diagnostic value of two-dimensional ultrasound and SWE in differentiating benign and malignant thyroid nodules with TI-RADS categories 3 to 5 was assessed using receiver operating characteristic(ROC)curve.Results The two-dimensional ultrasound features of nodules in the benign group were predominantly mixed echo,regular and clear edge,normal or enhanced posterior echo,large cystic cavity with coarse calcifications,and no surrounding infiltration.While those in the malignant group were low echo or equal echo,irregular and blurred edge,posterior echo attenuation,small cystic cavity with gravel-like calcifications,and partial surrounding infiltration.The Emax and Emean in the benign group were significantly lower than those in the malignant group(P<0.05).The TI-RADS classification based on two-dimensional ultrasound identified 79 cases(31.85%)of benign nodules and 169 cases(68.15%)of malignant nodules,with a Kappa value of 0.678 for consistency with pathological examination.SWE identified 59 cases(23.79%)of benign nodules and 189 cases(76.21%)of malignant nodules,with a Kappa value of 0.715 for consistency with pathological examination.The area under the curve(AUC)of two-dimensional ultrasound combined with SWE for diagnosing benign and malignant thyroid nodules was higher than that of either modality alone.Conclusion Both TI-RADS classification based on two-dimensional ultrasound and SWE can effectively differentiate the benign and malignant thyroid nodules with TI-RADS categories 3 to 5,and the combination of the two has higher diagnostic value.关键词
甲状腺结节/二维超声/剪切波弹性成像/甲状腺影像报告与数据系统分级/良恶性质/诊断价值Key words
thyroid nodules/two-dimensional ultrasound/shear wave elastography/thyroid imaging reporting and data system category/benign and malignant character/diagnostic value分类
医药卫生引用本文复制引用
姜舒,胥明婧,孙国强..二维超声联合剪切波弹性成像对TI-RADS分级3～5级甲状腺结节的诊断价值[J].局解手术学杂志,2026,35(5):380-384,5.基金项目
徐州市卫生健康委科技项目(XWKYHT20240092) （XWKYHT20240092）
