联合应用二维超声、彩色多普勒血流成像、超声造影及超声弹性成像技术并参照TI-RADS标准对甲状腺结节诊断价值的研究
|
摘要
目的:探讨联合应用二维超声(Two-dimensional Ultrasound,DUS)、彩色多普勒血流成像(Color Doppler Flow Imaging,CDFI)、超声造影(Contrast-enhanced Ultrasound,CEUS)及超声弹性成像(Ultrasonic Elastic Imaging,UE),参照甲状腺影像数字报告系统(Digital Thyroid Imaging Reporting System TI-RADS)标准对甲状腺结节良恶性鉴别的诊断价值。方法:回顾性分析自2014年5月至2018年5月在包头医学院第一附属医院接受甲状腺切除的甲状腺结节患者100例,共118个甲状腺结节超声图像特征,与病理学检查结果对照,应用χ~2检验分别分析各项超声指标图像特征及联合应用后对甲状腺结节的良恶性检出率。结果:以DUS、CDFI参照TI-RADS分级诊断甲状腺结节良恶性的敏感性、特异性及诊断准确性分别为55.6%、58.6%、57.8%;CEUS诊断甲状腺结节良恶性的敏感性、特异性及诊断准确性分别为80.6%、81.4%、73.9%; UE的敏感性、特异性及诊断准确性分别为68.8%、70.1%、74.7%;联合超声的敏感性、特异性及诊断准确性分别为93.8%、93.0%、93.2%。联合超声诊断和病理结果无差异(P=0.666>0.05)。结论:联合应用DUS、CDFI、CEUS及超声弹性成像技术并参照TI-RADS分级标准可收集更多的诊断信息进行综合分析,是一种更为全面,准确的甲状腺结节良恶性鉴别诊断方法。
Objective:To explore the diagnostic value of combining Two-dimensional Ultrasound(DUS), Color Doppler Flow Imaging(CDFI), Contrast-enhanced Ultrasound(CEUS) and Ultrasonic Elastic Imaging(UE) in the differential diagnosis of benign and malignant thyroid nodules with reference to Digital Thyroid Imaging Reporting System(TI-RADS). Methods:100 patients with thyroid nodules who underwent thyroidectomy in the First Affiliated Hospital of Baotou Medical College from May 2014 to May 2018 were retrospectively analyzed, including 118 thyroid nodule ultrasound image characteristics. Compared with the results of pathological examination, χ~2 test was used to analyze the image characteristics of various ultrasound indexes and the detection rate of benign and malignant thyroid nodules after combined application. Results:The sensitivity, specificity and diagnostic accuracy of DUS and CDFI in the diagnosis of benign and malignant thyroid nodules by referring to the TI-RADS were 55.6 %、58.6 % and 57.8 % respectively. The sensitivity, specificity and diagnostic accuracy of CEUS were 80.6 %、81.4 % and 73.9 % respectively. The same indexes of UE were 68.8 %、70.1 % and 74.7 % respectively. And those data of combined ultrasound were 93.8 %、93.0 % and 93.2 % respectively. There was no difference between combined ultrasound diagnosis and pathological results(P=0.666>0.05). Conclusion:Combined application of DUS, CDFI, CEUS and ultrasound elastography with reference to TI-RADS grading standard can collect more diagnostic information for comprehensive analysis, which is a more comprehensive and accurate method for differential diagnosis of benign and malignant thyroid nodules.
Objective:To explore the diagnostic value of combining Two-dimensional Ultrasound(DUS), Color Doppler Flow Imaging(CDFI), Contrast-enhanced Ultrasound(CEUS) and Ultrasonic Elastic Imaging(UE) in the differential diagnosis of benign and malignant thyroid nodules with reference to Digital Thyroid Imaging Reporting System(TI-RADS). Methods:100 patients with thyroid nodules who underwent thyroidectomy in the First Affiliated Hospital of Baotou Medical College from May 2014 to May 2018 were retrospectively analyzed, including 118 thyroid nodule ultrasound image characteristics. Compared with the results of pathological examination, χ~2 test was used to analyze the image characteristics of various ultrasound indexes and the detection rate of benign and malignant thyroid nodules after combined application. Results:The sensitivity, specificity and diagnostic accuracy of DUS and CDFI in the diagnosis of benign and malignant thyroid nodules by referring to the TI-RADS were 55.6 %、58.6 % and 57.8 % respectively. The sensitivity, specificity and diagnostic accuracy of CEUS were 80.6 %、81.4 % and 73.9 % respectively. The same indexes of UE were 68.8 %、70.1 % and 74.7 % respectively. And those data of combined ultrasound were 93.8 %、93.0 % and 93.2 % respectively. There was no difference between combined ultrasound diagnosis and pathological results(P=0.666>0.05). Conclusion:Combined application of DUS, CDFI, CEUS and ultrasound elastography with reference to TI-RADS grading standard can collect more diagnostic information for comprehensive analysis, which is a more comprehensive and accurate method for differential diagnosis of benign and malignant thyroid nodules.
引文
[1] Haugen BR,Alexander EK,Bible KC,et al.2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer:the American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer [J].Thyroid ,2016 ,26(1):1-133.
[2] 黄剑毅,王瑶,曾曦,等.CDFI与超声造影联合检测对甲状腺结节良恶性鉴别诊断的价值[J].医学临床研究,2016,33(6):1096-1098,1099.
[3] Hornung M,Jung EM,Georgieva M,et al.Detection of microvascularization of thyroid carcinomas using linear high resolution contrast enhanced ultrasonography(CEUS)[J].Clin Hemorheol Microcirc,2012,52(2-4):197-203.
[4] 李萍.超声弹性成像联合超声造影检测对甲状腺占位性病变的诊断价值分析 [J].中国医刊,2017,52(11):99-102.
[5] 李苗,刘娜,白亚莲,等.超声造影和超声弹性成像对甲状腺良恶性结节的鉴别诊断价值 [J].临床超声医学杂志,2017,30(8):516-520.
[6] Rago T,Santini F,Scutari M,et al.Elastography:new developments in ultrasound for predicting malignancy in thyroid nodules[J].J Clin Endocrinol Metab,2010,9(8):2917-2922.
[7] Bamber J,Cosgrove D,Dietrich CF,et al.EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography.Part 1:basic principles and technology[J].Ultraschall Med,2013,34(2):169-184.
[2] 黄剑毅,王瑶,曾曦,等.CDFI与超声造影联合检测对甲状腺结节良恶性鉴别诊断的价值[J].医学临床研究,2016,33(6):1096-1098,1099.
[3] Hornung M,Jung EM,Georgieva M,et al.Detection of microvascularization of thyroid carcinomas using linear high resolution contrast enhanced ultrasonography(CEUS)[J].Clin Hemorheol Microcirc,2012,52(2-4):197-203.
[4] 李萍.超声弹性成像联合超声造影检测对甲状腺占位性病变的诊断价值分析 [J].中国医刊,2017,52(11):99-102.
[5] 李苗,刘娜,白亚莲,等.超声造影和超声弹性成像对甲状腺良恶性结节的鉴别诊断价值 [J].临床超声医学杂志,2017,30(8):516-520.
[6] Rago T,Santini F,Scutari M,et al.Elastography:new developments in ultrasound for predicting malignancy in thyroid nodules[J].J Clin Endocrinol Metab,2010,9(8):2917-2922.
[7] Bamber J,Cosgrove D,Dietrich CF,et al.EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography.Part 1:basic principles and technology[J].Ultraschall Med,2013,34(2):169-184.