声触诊组织成像和定量技术在不同直径的甲状腺
TI-RADS 4类结节中的诊断价值

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摘要目的：探讨声触诊组织成像和定量技术（VTIQ）在不同直径甲状腺影像报告和数据系统（TI-RADS）4类结节中的诊断价值。方法：回顾性分析2015年10月—2017年1月经我院手术病理证实的191例患者195个甲状腺结节的TI-RADS和VTIQ图像资料。TI-RADS 4类结节按不同直径（≤10 mm和>10 mm）分成两组，测量结节在VTIQ上的横向剪切波速度（SWV），评价两组结节中各自TI-RADS、VTIQ及两者联合的诊断价值。绘制受试者操作特性（ROC）曲线，进行曲线下面积（AUC）两两比较及两组间比较。结果：195个结节中，恶性结节109个，良性结节86个。结节直径≤10 mm组中TI-RADS、VTIQ和两者联合诊断甲状腺癌敏感度、特异度、阳性预测值、阴性预测值、准确度、AUC分别为70.00%、95.24%、94.50%、72.72%、81.52%、0.826；82.00%、78.57%、82.00%、78.57%、80.43%、0.803及96.00%、76.19%、82.76%、94.12%、86.96%、0.861。结节直径>10 mm组中TI-RADS、VTIQ和两者联合诊断甲状腺癌敏感度、特异度、阳性预测值、阴性预测值、准确度、AUC分别为67.80%、90.91%、90.91%、67.80%、77.67%、0.794；79.66%、79.55%、83.93%、74.47%、79.61%、0.796及91.53%、75.00%、83.08%、86.84%、84.87%、0.833。两组间三种方法比较均没有统计学意义。结论：VTIQ技术在不同直径的TI-RADS 4类结节中均有诊断价值，而两者的VTIQ与TI-RADS联合应用的敏感度更高。在不同直径的分组中TI-RADS、VTIQ及两者联合诊断效能比较，结节直径≤10 mm组稍具优势。

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	刘淼
	沈燕
	傅晓红
	吴墅
	何洁

关键词 ：甲状腺结节, 超声检查

Abstract：Objective: To assess the value of virtual touch tissue imaging quantification(VTIQ) in different diameter TI-RADS 4 thyroid nodules on ultrasound. Methods: 191 patients with 195 pathologically proven benign(86) and malignant(109) thyroid nodules underwent TI-RADS and VTIQ examinations, and all the nodules were identified as TI-RADS 4． The thyroid nodules of TI-RADS 4 were divided into two groups according to diameter(≤10 mm and >10 mm)． Shear wave velocity(SWV) were measured with VTIQ. To assess the diagnostic value of TI-RADS, VTIQ and their combination in each group, the receiver operating characteristic(ROC) curves of TI-RADS, VTIQ and their combination were drawn in two groups. Areas under the curve(AUC) were compared between the two groups． Results: The sensitivity, specificity, positive predictive value, negative predictive value, accuracy and AUC of TI-RADS, VTIQ and their combination for the group(diameter≤10 mm) were 70.00%, 95.24%, 94.50%, 72.72%, 81.52%, 0.826; 82.00%, 78.57%, 82.00%, 78.57%, 80.43%, 0.803 and 96.00%, 76.19%, 82.76%, 94.12%, 86.96%, 0.861. In another group(diameter>10 mm), the sensitivity, specificity, positive predictive value, negative predictive value, accuracy and AUC were 67.80%, 90.91%, 90.91%, 67.80%, 77.67%, 0.794; 79.66%, 79.55%, 83.93%, 74.47%, 79.61%, 0.796 and 91.53%, 75.00%, 83.08%, 86.84%, 84.87%, 0.833. Three methods compared between the two groups have no statistically difference. Conclusion: It’s of high value for VTIQ to differentiate benign and malignant ones in different diameter TI-RADS 4 thyroid nodules. The sensitivity of the combination method was better than that single method. Between two groups, it’s better for the group which diameter≤10 mm in using VTIQ and their combination.

Key words： Thyroid nodule Ultrasonography

收稿日期: 2017-02-07

PACS:	Ｒ581
	Ｒ445.1

通讯作者: 傅晓红，上海市浦东新区公利医院超声科，200135。E-mail：fuxiaohong66@163.com

作者简介: 刘淼（1980-），女，浙江人，主治医师。E-mail：miaomiao.lm@163.com

引用本文:

刘淼，沈燕，傅晓红，吴墅，何洁. 声触诊组织成像和定量技术在不同直径的甲状腺 TI-RADS 4类结节中的诊断价值[J]. 中国临床医学影像杂志, 2017, 28(11): 764-769.
LIU Miao, SHEN Yan, FU Xiao-hong, WU Shu, HE Jie. Value of virtual touch tissue imaging quantification in different diameter TI-RADS 4 thyroid nodules. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(11): 764-769.

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http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2017/V28/I11/764

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