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目的评价甲状腺影像学报告及数据统计(TI-RADS)分级联合弹性应变率比值(SR)在桥本病(HT)合并结节时良恶性鉴别诊断的价值。方法回顾性分析经手术病理证实的100例HT合并结节患者的临床资料,所有患者均接受灰阶超声及弹性成像技术的检查。计算TI-RADS分级、SR以及两者联合诊断HT合并结节时良恶性的敏感度、特异度、准确度。绘制TI-RADS分级、SR以及二者联合诊断的ROC曲线,比较ROC曲线下面积。结果病理诊断17例患者合并恶性结节,83例合并良性结节。TI-RADS分级诊断恶性结节患者22例,良性结节78例,敏感度、特异度及准确度分别为76.47%、89.16%、87.00%;SR诊断良性结节77例,恶性结节23例,诊断敏感度、特异度及准确度分别为88.24%、90.36%、90.00%;良恶性结节的SR值分别为(1.72±0.59)、(5.98±2.44),差异有统计学意义(P<0.05);SR的敏感度及准确度均高于TI-RADS分级;二者联合诊断良性结节73例,恶性结节27例,诊断敏感度、特异度及准确度分别为100.00%、87.95%及90.00%。TI-RADS分级、SR以及二者联合诊断的ROC曲线下面积分别为0.6154、0.6598、0.7112,二者联合诊断价值高于单一方法。结论 TI-RADS分级联合SR能提高对HT合并结节性质诊断的敏感度及准确度。
Objective To evaluate the differential diagnosis of benign and malignant lesions in Hashimoto’s disease (HT) with nodular joint elastic strain ratio (SR) based on TI-RADS report and data statistics (TI-RADS). Methods The clinical data of 100 patients with HT combined nodules confirmed by surgery and pathology were retrospectively analyzed. All patients underwent gray - scale ultrasound and elastography. The sensitivity, specificity and accuracy of TI-RADS classification, SR, and combined diagnosis of HT combined nodules were calculated. ROC curves were plotted for the TI-RADS classification, the SR, and the combination of the two, and the area under the ROC curve was compared. Results Pathological diagnosis of 17 patients with malignant nodules, 83 patients with benign nodules. Twenty-two patients with malignant nodules and 78 benign nodules were diagnosed by TI-RADS. The sensitivity, specificity and accuracy of TI-RADS were 76.47%, 89.16% and 87.00% respectively. SR diagnosed 77 benign nodules and 23 malignant nodules The diagnostic sensitivity, specificity and accuracy were 88.24%, 90.36% and 90.00% respectively. The SR values of benign and malignant nodules were (1.72 ± 0.59) and (5.98 ± 2.44), respectively, with significant difference (P < 0.05). The sensitivity and accuracy of SR were higher than that of TI-RADS classification. The combined diagnosis of 73 benign nodules and 27 malignant nodules showed that the sensitivity, specificity and accuracy of SR were 100.00%, 87.95% And 90.00%. The area under the ROC curve of TI-RADS classification, SR and the combined diagnosis of the two were 0.6154, 0.6598 and 0.7112, respectively. The diagnostic value of TI-RADS was higher than that of single method. Conclusion TI-RADS grading combined with SR can improve the sensitivity and accuracy of the diagnosis of HT combined nodules.