Diagnostic value of ultrasonic elastic strain ratio and elasticity score for thyroid micronodules of TI-RADS 4
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摘要: 目的: 探讨实时组织弹性成像应变率比值法及弹性评分法对甲状腺TI-RADS 4类微小结节的诊断价值。方法: 选取有甲状腺微小结节的211例患者(225枚结节),所有结节术前均采用TI-RADS分类诊断标准进行评价并行弹性成像检查。以病理结果为"金标准",弹性应变率比值及弹性评分为结果,绘制ROC曲线,分析曲线下面积。结果: 甲状腺良、恶性微小结节的弹性应变率比值及弹性评分之间均差异有统计学意义(P<0.05)。弹性应变率比值曲线下面积(0.935)与弹性评分曲线下面积(0.825)差异有统计学意义(P<0.05);以弹性应变率比值 ≥ 3.45为诊断临界值,诊断甲状腺恶性结节的敏感度、特异度、准确度分别为85.51%、90.32%、87.56%;以弹性评分 ≥ 3为诊断临界值,诊断甲状腺恶性结节的敏感度、特异度、准确度分别为80.98%、79.03%、80.44%。结论: 超声弹性成像应变率比值法及弹性评分法对甲状腺TI-RADS 4类微小结节具很高的诊断价值,应变率比值法更有优势。Abstract: Objective: To investigate diagnostic value of ultrasonic elastic strain ratio and elasticity score for thyroid micronodules of TI-RADS 4. Method: In total, 211 consecutive patients with 225 thyroid micronodules were enroled in the study, all the nodules were evaluated by TI-RADS criteria before and all of them were examined by elastic imaging. We set the histology as the reference standard. The elastic strain ratio and elasticity score values, as well as their diagnostic threshold and efficiency, were compared and analyzed by the receiver-operating characteristic(ROC) curve. Result: Statistically significant differences(P<0.05) in both elastic strain ratio and elasticity score values were detected among the thyroid microcarcinoma and benign groups. The area under the ROC curve of elastic strain ratio was significantly greater than that of elasticity score(0.935 and 0.825, respectively; P<0.05). Using elastic strain ratio ≥ 3.45 and elasticity score ≥ 3.00 as diagnostic threshold values, the diagnostic sensitivity, specificity, and accuracy of elastic strain ratio for differentiating benign and malignant nodules were 86.51%, 90.32%, and 87.56%, respectively, whereas those of elasticity score were 80.98%, 79.03% and 80.44%, respectively.Conclusion: Ultrasonic elastic strain ratio and elasticity score have very high diagnostic value for the thyroid micronodules of TI-RADS 4, and strain ratio has more advantages.
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Key words:
- thyroid nodule /
- ultrasound elastosonography /
- elastic strain ratio /
- elasticity score
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