超微血管成像联合高频超声对弥漫性甲状腺病背景下甲状腺结节良恶性的诊断价值

Diagnostic value of superb microvascular imaging combined with high-frequency ultrasound for benign and malignant thyroid nodules in diffuse thyroid disease

摘要:

目的 探讨超微血管成像（SMI）联合高频超声对弥漫性甲状腺病背景下甲状腺结节良恶性的诊断价值。方法 前瞻性选取2020年1月—2021年12月萍乡矿业集团有限责任公司总医院收治的121例弥漫性甲状腺病背景下甲状腺结节患者为研究对象，所有患者行SMI、高频超声检查，以病理诊断作为金标准。结果 121例弥漫性甲状腺病背景下甲状腺结节患者经临床病理检查，38例为恶性甲状腺结节，83例为良性甲状腺结节。SMI检查121例弥漫性甲状腺病背景下甲状腺结节患者，结果恶性甲状腺结节51例，良性甲状腺结节70例。高频超声检查121例弥漫性甲状腺病背景下甲状腺结节患者，结果恶性甲状腺结节53例，良性甲状腺结节68例。恶性结节组患者结节结构、结节回声、结节形态、结节边缘、结节钙化灶甲状腺影像-报告和数据系统（TI-RADS）评分均高于良性结节组（P <0.05）。ROC曲线结果显示，SMI、高频超声及两者联合诊断弥漫性甲状腺病背景下甲状腺结节良恶性的敏感性分别为81.58%（95% CI：0.651，0.917）、78.95%（95% CI：0.621，0.899）和94.74%（95% CI：0.809，0.991），特异性分别为75.90%（95% CI：0.650，0.843）、72.29%（95% CI：0.612，0.813）和98.80%（95% CI：0.925，0.999），AUC分别为0.922（95% CI：0.873，0.970）、0.910（95% CI：0.857，0.962）和0.987（95% CI：0.957，1.000）。结论 SMI联合高频超声可提高弥漫性甲状腺病背景下甲状腺结节良恶性的诊断效能。

Abstract:

Objective To investigate the value of superb microvascular imaging (SMI) combined with high-frequency ultrasound in the diagnosis of benign and malignant thyroid nodules in diffuse thyroid disease.Methods A total of 121 patients with thyroid nodules and diffuse thyroid disease who were admitted to the hospital from January 2020 to December 2021 were selected for the prospective study. All patients underwent SMI and high-frequency ultrasound scan, and pathological diagnosis was used as the gold standard.Results The clinicopathological findings of the 121 patients showed that 38 of them had malignant thyroid nodules and 83 had benign thyroid nodules. The SMI diagnosed 51 malignant thyroid nodules and 70 benign thyroid nodules, while the high-frequency ultrasound diagnosed 53 malignant thyroid nodules and 68 benign thyroid nodules. The scores of composition, echogenicity, shape, margin, echogenic foci of the thyroid nodules as assessed via the Thyroid Imaging-Reporting and Data System (TI-RADS) in malignant nodule group were all higher than those in benign nodule group (P < 0.05). The receiver operating characteristic (ROC) curve analysis showed that the sensitivities of SMI, high-frequency ultrasound and their combination in diagnosing benign and malignant thyroid nodules in diffuse thyroid disease were 81.58% (95% CI: 0.651, 0.917), 78.95% (95% CI: 0.621, 0.899), and 94.74% (95% CI: 0.809, 0.991). The specificities were 75.90% (95% CI: 0.650, 0.843), 72.29% (95% CI: 0.612, 0.813), and 98.80% (95% CI: 0.925, 0.999). The areas under the ROC curves (AUCs) were 0.922 (95% CI: 0.873, 0.970), 0.910 (95% CI: 0.857, 0.962), and 0.987 (95% CI: 0.957, 1.000).Conclusions SMI combined with high-frequency ultrasound increases the diagnostic performance for benign and malignant thyroid nodules in diffuse thyroid disease.