瘤周超声黏弹性成像技术联合C-TIRADS对甲状腺结节良恶性的鉴别诊断价值OA

Objective:To explore the value of combining perinodular ultrasound viscoelastic imaging parameters with the C-TIRADS in the differential diagnosis of benign and malignant thyroid nodules.Methods:A total of 203 thyroid nodules from 152 patients were prospectively enrolled.All nodules underwent conventional ultrasound,ultrasound viscoelastic imaging,and shear wave elastography before biopsy or surgery.Elastic and viscoelastic parameters of both the intranodular and perinodular(2 mm)areas were measured.Receiver operating characteristic(ROC)curves were plotted to identify the optimal elastic and viscoelastic parameters.The C-TIRADS categories were then adjusted based on their cut-off values,and the diagnostic performance of the combined models was compared with that of C-TIRADS alone.Results:The maximum elastic parameter(S-Emax)and maximum dispersion parameter(S-Dmax)of the perinodular tissue were identified as the optimal parameters.The AUC,specificity,sensitivity,and accuracy of C-TIRADS alone were 0.744,69.44％,74.05％,and 72.41％,respectively.After adjusting the C-TIRADS categories using the optimal cut-off values of S-Emax and S-Dmax,the diagnostic accuracy of the combined models was 81.28％and 82.76％,with AUC values of 0.817 and 0.846,respectively,both significantly higher than that of the individual C-TIRADS diagnosis(all P＜0.05).However,there was no statistically significant difference between the two combined models.Conclusion:Ultrasound viscoelastic imaging exhibits diagnostic efficacy comparable to shear wave elastography in differentiating benign and malignant thyroid nodules.Both techniques significantly improve the diagnostic performance of C-TIRADS,demonstrating important clinical application value.