【摘要】 目的 应用弹性对比指数对甲状腺ACR-TIRADS 4类的结节再分层,研究弹性成像对中度可疑结节细化分类的可行性,并与初始TIRADS分类系统诊断效能进行比较。方法 纳入136人194例获得病理结果的甲状腺结节,应用ACR-TIRADS进行分类,并测量弹性对比指数(ECI)。依据ECI将ACR-TIRADS 4类结节细分为4a和4b。比较两种方法诊断效能。结果ROC曲线下面积最大的是加入ECI分层的TIRADS(0.872),其次是ACR-TIRADS(0.868)。但两者曲线下面积无统计学差异。加入ECI对TIRADS 4类的结节进行分层后,特异性和阳性预测值较初始TIRADS分类提高。结论 ECI作为应变弹性成像半定量的方法,能够辅助对TIRADS 4类的结节进行分层,提高ACR-TIRADS特异性和阳性预测值。更多还原

【Abstract】 Objective To study the feasibility of elastography for the detailed classification of moderately suspicious nodules by applying elasticity contrast index(ECI) to restratify nodules of thyroid ACR-TIRADS class 4, and to compare the diagnostic efficiency with the initial TIRADS classification system. Methods A total of 136 patients with malignant nodules were enrolled from 194 patients with thyroid nodules with pathological findings. The nodules were classified by ACR-TIRADS, and were measured by ECI. The nodules of TIRADS 4 were divided into 4a and 4b according to their ECI. The diagnostic efficiency was compared with the initial ACR TIRADS classification system. Results The largest area under the ROC curve was 0.872 at TIRADS with ECI stratification, followed by ACR-TIRADS(0.868). However, there was no statistically significant difference in the area under the curve between the two. Stratification of TIRADS class 4 nodules with the addition of ECI resulted in improved specificity and positive predictive values compared to the initial TIRADS classification. Conclusions ECI is a semi-quantitative method for strain elastography to assist in the stratification of TIRADS class 4 nodules and to improve the specificity and positive predictive value of ACR-TIRADS.更多还原