【摘要】 目的 探讨超声造影联合甲状腺影像报告和数据系统（TI-RADS）在甲状腺良恶性结节鉴别诊断中的应用价值。方法 选取2016年12月至2021年2月我院收治的227例甲状腺结节患者作为研究对象，患者均进行超声造影、TI-RADS检查。以病理诊断结果为金标准，分析甲状腺结节患者的病理诊断结果；分析并比较超声造影、TI-RADS、超声造影联合TI-RADS对甲状腺良恶性结节鉴别诊断的效能。结果 227例甲状腺结节患者经病理诊断确诊良性结节125例，包括结节性甲状腺肿并出血囊性变2例，慢性淋巴细胞性甲状腺炎2例，肉芽肿性甲状腺炎1例，亚急性甲状腺炎5例，甲状腺腺瘤10例，结节性甲状腺肿105例；恶性结节102例，包括甲状腺髓样癌2例，甲状腺滤泡癌5例，甲状腺乳头状癌95例。超声造影诊断甲状腺恶性结节的灵敏度为88.24%，特异度为85.60%，准确度为86.78%。TI-RADS诊断甲状腺恶性结节的灵敏度为85.29%，特异度为87.20%，准确度为86.34%。超声造影联合TI-RADS诊断甲状腺恶性结节的灵敏度为95.10%，特异度为96.80%，准确度为96.04%。超声造影联合TI-RADS诊断甲状腺恶性结节的灵敏度、特异度及准确度高于超声造影、TI-RADS，差异具有统计学意义（P<0.05）。结论 超声造影联合TI-RADS可提高甲状腺结节性质的诊断效能，值得进一步推广应用。更多还原

【Abstract】 Objective To explore the application value of contrast-enhanced ultrasound combined with thyroid imaging reporting and data system(TI-RADS) in the differential diagnosis of benign and malignant thyroid nodules. Methods A total of 227 patients with thyroid nodules admitted in our hospital from December 2016 to February 2021 were selected as the research objects, all patients were examined by contrast-enhanced ultrasound and TI-RADS. The pathological diagnosis was the gold standard, pathological diagnosis rusults of patients with thyroid nodules was analyzed; the efficacy of contrastenhanced ultrasound, TI-RADS and contrast-enhanced ultrasound combined with TI-RADS in the differential diagnosis of benign and malignant thyroid nodules were analyzed and compared. Results Of the 227 patients with thyroid nodules, 125 were diagnosed as benign nodules, there were 2 cases of nodular goiter with hemorrhagic cystic degeneration, 2 cases of chronic lymphocytic thyroiditis, 1 case of granulomatous thyroiditis, 5 cases of subacute thyroiditis, 10 cases of thyroid adenoma and 105 cases of nodular goiter; 102 were diagnosed as malignant nodules, there were 2 cases of medullary thyroid carcinoma, 5 cases of follicular thyroid carcinoma and 95 cases of papillary thyroid carcinoma. The sensitivity, specificity and accuracy of contrast-enhanced ultrasound in the diagnosis of malignant thyroid nodules were 88.24%, 85.60% and 86.78%, respectively. The sensitivity, specificity and accuracy of TI-RADS in the diagnosis of malignant thyroid nodules were 85.29%, 87.20% and 86.34%, respectively. The sensitivity, specificity and accuracy of contrast-enhanced ultrasound combined with TI-RADS in the diagnosis of malignant thyroid nodules were 95.10%, 96.80% and 96.04%, respectively. The sensitivity, specificity and accuracy of contrast-enhanced ultrasound combined with TI-RADS in the diagnosis of malignant thyroid nodules were higher than those of contrast-enhanced ultrasound and TI-RADS, and the differences were statistically significant(P<0.05). Conclusion The contrast-enhanced ultrasound combined with TI-RADS can improve the diagnostic efficacy of thyroid nodules nature, which is worthy of further promotion and application.更多还原