超声造影联合中国甲状腺影像报告和数据系统在甲状腺结节诊断和活检效能中的研究

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摘要目的探讨中国甲状腺影像报告和数据系统（C-TIRADS）联合超声造影在诊断甲状腺结节的价值。方法选取2022年1月至6月在广西医科大学第一附属医院超声科接受超声检查的413例甲状腺结节患者（413个结节）作为研究对象，以病理学检查结果为“金标准”，所有患者均进行C-TIRADS分类及其联合超声造影检查。比较C-TIRADS分类、C-TIRADS分类联合超声造影检查的灵敏度、特异度及准确度；并分别根据C-TIRADS指南和C-TIRADS指南联合超声造影进行推荐甲状腺活检，分别计算并比较两种方法的恶性肿瘤的活检产量、恶性肿瘤的活检率以及不必要的活检率。结果 C-TIRADS检查结果诊断良性结节363例，恶性结节50例；C-TIRADS联合超声造影检查结果诊断良性结节267例，恶性结节146例。C-TIRADS联合超声造影检查的诊断甲状腺癌的灵敏度、特异度、准确度均高于应用C-TIRADS检查，差异有统计学意义（P＜0.05）。所有结节、1.0～1.5 cm结节中，C-TIRADS联合超声造影的恶性肿瘤活检率低于C-TIRADS单独分类，＞1.5 cm结节中，C-TIRADS联合超声造影的恶性肿瘤活检率、不必要活检率均低于C-TIRADS单独分类，差异有统计学意义（P＜0.05）。结论 C-TIRADS与超声造影相联合可提高甲状腺结节的超声诊断效能，并且将超声造影联合C-TIRADS去推荐甲状腺活检也能提高推荐甲状腺结节活检的可靠性，在增加恶性结节的活检产率的同时还能减少甲状腺良性结节的不必要活检率。

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	阳玉晶杨红▲ 文荣高瑞智

关键词 ：甲状腺结节, 中国甲状腺影像报告和数据系统, 超声造影, 诊断效能, 不必要活检率

Abstract：Objective To investigate the value of Chinese-thyroid imaging, reporting and data system (C-TIRADS) combined with contrast-enhanced ultrasound in the diagnosis of thyroid nodules. Methods A total of 413 patients with thyroid nodules (413 nodules) who received ultrasound examination in the Department of Ultrasound Medicine, the First Affiliated Hospital of Guangxi Medical University from January to June 2022 were selected as the study objects. With pathological findings as the "gold standard", all patients were classified by C-TIRADS and combined with contrast-enhanced ultrasound. The sensitivity, specificity and accuracy of C-TIRADS classification and C-TIRADS classification combined with contrast-enhanced ultrasound were compared. The recommended thyroid biopsy was performed according to the C-TIRADS guideline and the C-TIRADS guideline combined with contrast-enhanced ultrasound, and the biopsy yield of malignant tumors, the biopsy rate of malignant tumors and the rate of unnecessary biopsies were calculated and compared respectively. Results The results of C-TIRADS showed 363 benign nodules and 50 malignant nodules. C-TIRADS combined with contrast-enhanced ultrasound were used to diagnose 267 benign nodules and 146 malignant nodules. The sensitivity, specificity and accuracy of C-TIRADS combined with contrast-enhanced ultrasound in the diagnosis of thyroid cancer were higher than those of C-TIRADS, and the differences were statistically significant (P＜0.05). For all nodules, 1.0-1.5 cm nodules, the biopsy rate of malignant tumors with C-TIRADS combined with contrast-enhanced ultrasound was lower than that of C-TIRADS alone. For nodules＞1.5 cm, the biopsy rate of malignant tumor and unnecessary biopsy rate of C-TIRADS combined with contrast-enhanced ultrasound were lower than that of C-TIRADS alone, the differences were statistically significant (P＜0.05). Conclusion The combination of C-TIRADS and contrast ultrasound can improve the ultrasound diagnostic efficiency of thyroid nodules, and contrast ultrasound combined with C-TIRADS can also improve the reliability of recommending thyroid nodules biopsy, increase the biopsy yield of malignant nodules, and reduce the unnecessary biopsy rate of benign thyroid nodules.

Key words： Thyroid nodule Chinese-thyroid imaging, reporting and data system Contrast-enhanced ultrasound Diagnostic effectiveness Unnecessary biopsy rate

通讯作者: ▲通讯作者

作者简介: 阳玉晶（1983-），男，广西桂林人，副主任医师，同时就职于桂林医学院第二附属医院超声医学科；研究方向：超声造影与介入治疗。

引用本文:

阳玉晶杨红▲ 文荣高瑞智. 超声造影联合中国甲状腺影像报告和数据系统在甲状腺结节诊断和活检效能中的研究[J]. 中国当代医药, 2024, 31(1): 81-84.
YANG Yujing YANG Hong▲ WEN Rong GAO Ruizhi. Study of contrast-enhanced ultrasound combined with Chinese-thyroid imaging, reporting and data system in the diagnosis and biopsy efficiency of thyroid nodules. 中国当代医药, 2024, 31(1): 81-84.

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https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2024/V31/I1/81

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