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OA
Diagnostic value of two-dimensional ultrasound combined with shear wave elastography for thyroid nodules with TI-RADS categories 3 to 5
目的 探究二维超声联合剪切波弹性成像(SWE)在甲状腺影像报告与数据系统(TI-RADS)分级3～5级甲状腺结节中的诊断价值.方法 回顾性分析2023年1月至2025年1月我院接收的248例TI-RADS分级3～5级甲状腺结节患者的临床资料,根据病理诊断结果,将患者分为良性组(n=75)与恶性组(n=173).统计2组患者二维超声特征及可疑结节最大杨氏模量(Emax)与平均杨氏模量(Emean).分析二维超声、SWE对甲状腺结节良恶性的诊断情况及其与病理诊断结果的一致性.采用受试者工作特征(ROC)曲线分析二维超声及SWE对TI-RADS分级3～5级甲状腺结节良恶性的诊断价值.结果 良性组患者结节二维超声特征以混回声、边缘规则清晰、后方回声正常或增强、囊腔大且钙化呈大颗粒、周围无浸润为主;恶性组患者结节二维超声特征以低回声或等回声、边缘不规则模糊、后方回声衰减、囊腔小且钙化呈沙砾状、周围存在部分浸润为主.良性组患者Emax、Emean均显著低于恶性组(P<0.05).基于二维超声的TI-RADS分级鉴别出良性结节79例(31.85%),恶性结节169例(68.15%),与病理检查的一致性Kappa值为0.678;SWE鉴别出良性结节59例(23.79%),恶性结节189例(76.21%),与病理检查的一致性Kappa值为0.715.二维超声联合SWE诊断甲状腺结节良恶性的曲线下面积(AUC)高于二者单独诊断.结论 基于二维超声的TI-RADS分级与SWE均可有效鉴别TI-RADS分级3～5级甲状腺结节的良恶性,二者联合具有更高的诊断价值.
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.
姜舒;胥明婧;孙国强
徐州市第一人民医院超声科,江苏 徐州 221000徐州市第一人民医院超声科,江苏 徐州 221000徐州市第一人民医院超声科,江苏 徐州 221000
医药卫生
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
thyroid nodulestwo-dimensional ultrasoundshear wave elastographythyroid imaging reporting and data system categorybenign and malignant characterdiagnostic value
《局解手术学杂志》 2026 (5)
380-384,5
徐州市卫生健康委科技项目(XWKYHT20240092)
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