C-TIRADS 联合超声弹性成像技术对甲状腺结节的诊断性能。
Diagnostic performance of C-TIRADS combined with SWE for the diagnosis of thyroid nodules.
机构信息
Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin, China.
出版信息
Front Endocrinol (Lausanne). 2022 Sep 6;13:939303. doi: 10.3389/fendo.2022.939303. eCollection 2022.
OBJECTIVE
To explore the value of the optimal parameters of shear wave elastography (SWE) to enhance the identification of benign and malignant thyroid nodules by C-TIRADS.
METHODS
The two-dimensional ultrasonography images and SWE images of 515 patients with a total of 586 thyroid nodules were retrospectively analyzed. The nodules were divided into the D ≤10 mm and D >10 mm groups according to size and were graded by C-TIRADS. With the pathological results as the gold standard, the receiver operating characteristic (ROC) curves were drawn, and the area under the curve (AUC) was calculated to compare the diagnostic performances of C-TIRADS, SWE, and the combination of the two on the benign and malignant thyroid nodules.
RESULTS
The ROC showed that the AUC of the maximum elastic modulus (0.875) was higher than that of the mean elastic modulus (0.798) and elasticity ratio (0.772), with an optimal cutoff point of 51 kPa, which was the optimal parameter to distinguish the malignant from the benign nodules ( < 0.001). In the D ≤10 mm group, the AUC of TIRADS combined with SWE (0.955) was elevated by 0.172 compared with the application of C-TIRADS alone (0.783), and the difference was statistically significant ( < 0.05). In the D >10 mm group, the AUC of TIRADS combined with SWE (0.904) was elevated by 0.076 compared with the application of C-TIRADS alone (0.828), and the difference was statistically significant ( < 0.05). Among all nodules, the application of C-TIRADS alone had a sensitivity of 88.14%, a specificity of 74.56%, and an accuracy of 85.50% in diagnosing benign and malignant thyroid nodules, while the sensitivity, specificity, and accuracy were 93.22%, 90.35%, and 92.66%, respectively, in combination with SWE.
CONCLUSION
The diagnostic performance of SWE in combination with TIRADS was better than that of SWE or C-TIRADS alone. Here, SWE enhanced the diagnostic performance of C-TIRADS for the benign and malignant thyroid nodules, most significantly for nodules with D ≤10 mm.
目的
探讨剪切波弹性成像（SWE）最佳参数对 C-TIRADS 增强甲状腺良恶性结节鉴别的价值。
方法
回顾性分析 515 例共 586 个甲状腺结节的二维超声图像和 SWE 图像。根据结节大小分为 D≤10mm 和 D＞10mm 两组，采用 C-TIRADS 分级。以病理结果为金标准，绘制受试者工作特征（ROC）曲线，计算曲线下面积（AUC），比较 C-TIRADS、SWE 及两者联合对甲状腺良恶性结节的诊断效能。
结果
ROC 显示最大弹性模量（0.875）的 AUC 高于平均弹性模量（0.798）和弹性比（0.772），最佳截断点为 51kPa，可较好地区分良恶性结节（＜0.001）。在 D≤10mm 组中，TIRADS 联合 SWE（0.955）的 AUC 比单独应用 C-TIRADS（0.783）升高 0.172，差异有统计学意义（＜0.05）。在 D＞10mm 组中，TIRADS 联合 SWE（0.904）的 AUC 比单独应用 C-TIRADS（0.828）升高 0.076，差异有统计学意义（＜0.05）。在所有结节中，单独应用 C-TIRADS 诊断甲状腺良恶性结节的敏感度为 88.14%，特异度为 74.56%，准确度为 85.50%，联合 SWE 后敏感度、特异度和准确度分别为 93.22%、90.35%和 92.66%。
结论
SWE 联合 TIRADS 的诊断性能优于 SWE 或 C-TIRADS 单独应用，SWE 增强了 C-TIRADS 对甲状腺良恶性结节的诊断效能，对 D≤10mm 的结节作用更明显。
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