对因活检而转诊的甲状腺结节患者进行虚拟触诊组织成像定量分析及超声甲状腺影像报告和数据系统评估。

Assessment of Virtual Touch Tissue Imaging Quantification and the Ultrasound Thyroid Imaging Reporting and Data System in Patients With Thyroid Nodules Referred for Biopsy.

作者信息

Mao Feng, Xu Hui-Xiong, Zhou Hang, Bo Xiao-Wan, Li Xiao-Long, Li Dan-Dan, Liu Bo-Ji, Zhang Yi-Feng, Xu Jun-Mei, Qu Shen

机构信息

Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Shanghai, China.

Thyroid Institute, Tongji University School of Medicine, Shanghai, China.

出版信息

J Ultrasound Med. 2018 Mar;37(3):725-736. doi: 10.1002/jum.14413. Epub 2017 Sep 28.

Abstract

OBJECTIVES

To evaluate the diagnostic performance of Virtual Touch tissue imaging quantification (VTIQ; Siemens Medical Solutions, Mountain View, CA) in combination with the Thyroid Imaging Reporting and Data System (TI-RADS) for assessing thyroid nodules referred for biopsy.

METHODS

A total of 197 surgically or cytologically proven thyroid nodules in 187 patients were included. Nodules evaluated by conventional ultrasound (US) and VTIQ examinations were classified into US TI-RADS categories. The shear wave velocity (SWV) on VTIQ was assessed, and the cutoff value was obtained from a receiver operating characteristic curve analysis. Diagnostic performances of conventional US, VTIQ, and their combination were compared.

RESULTS

There were 134 benign and 63 malignant nodules. The sensitivity and specificity for the US TI-RADS were 98.4% and 20.1%, respectively. The areas under the receiver operating characteristic curves for the mean, maximum, minimum, and ratio of the SWV were 0.818, 0.805, 0.799, and 0.728. With a cutoff value of 2.90 m/s, the sensitivity and specificity of the mean SWV were 71.4% and 82.8%. By applying this value or less as a standard for downgrading TI-RADS category 4a to category 3 lesions, the specificity significantly rose from 20.1% to 47.0% (P < .001) without a loss of sensitivity.

CONCLUSIONS

The additional application of VTIQ can improve the specificity of the TI-RADS for evaluating thyroid nodules without a loss of sensitivity.

摘要

目的

评估虚拟触诊组织成像定量技术(VTIQ;西门子医疗解决方案公司,加利福尼亚州山景城)联合甲状腺影像报告和数据系统(TI-RADS)对需活检的甲状腺结节的诊断性能。

方法

纳入187例患者共197个经手术或细胞学证实的甲状腺结节。通过传统超声(US)和VTIQ检查评估的结节被分类为US TI-RADS类别。评估VTIQ上的剪切波速度(SWV),并通过受试者操作特征曲线分析获得临界值。比较传统US、VTIQ及其联合应用的诊断性能。

结果

有134个良性结节和63个恶性结节。US TI-RADS的敏感性和特异性分别为98.4%和20.1%。SWV均值、最大值、最小值及比值的受试者操作特征曲线下面积分别为0.818、0.805、0.799和0.728。以2.90 m/s为临界值,SWV均值的敏感性和特异性分别为71.4%和82.8%。将此值及以下作为将TI-RADS 4a类病变降级为3类病变的标准应用后,特异性从20.1%显著提高至47.0%(P < 0.001),且不损失敏感性。

结论

VTIQ的额外应用可提高TI-RADS评估甲状腺结节的特异性且不损失敏感性。

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