郑斌

【摘要】 目的：探讨超声弹性成像及甲状腺影报告与数据系统（TI-RADS）联合对良恶性甲状腺结节的诊断价值。方法：选取2017年1月-2018年1月本院收治的甲状腺结节患者100例（115个病灶），患者均行超声弹性成像及TI-RADS检查，对单一检查方法及联合检查的诊断效能进行计算比较。

结果：115个结节中均经手术病理或组织学穿刺活检证实，其中良性79个，恶性36个；联合诊断特异度、准确度、敏感度均高于TI-RADS分级、弹性成像，比较差异均有统计学意义（P<0.05）；单一诊断中弹性成像特异度、准确度均高于TI-RADS分级，但比较差异均无统计学意义（P>0.05）。结论：超声弹性成像及TI-RADS联合对良恶性甲状腺结节的诊断价值较高，具有临床推广价值。

【关键词】 甲状腺结节良恶性； 弹性成像； TI-RADS

Application Value of TI-RADS Plus Ultrasonic Elastography in the Sonographic Diagnosis of Benign and Malignant Thyroid Nodules/ZHENG Bin.//Medical Innovation of China，2018，15（27）：0-064

【Abstract】 Objective：To discuss the diagnosis value of ultrasonic elastography plus thyroid imaging reporting and data system（TI-RADS）in benign and malignant thyroid nodules.Method：A total of 100 patients with thyroid nodules（115 lesions） treated in our hospital from January 2017 to January 2018 were selected.The ultrasonic elastography plus TI-RADS were applied.The diagnosis efficiency based on the single examination and combined examinations were compared.Result：Through the operation and pathological examination or histological biopsy，115 lesions were proved with 79 benign lesions and 36 malignant lesions.The specificity，accuracy and sensitivity of combined diagnosis were higher than those of TI-RADS classification and ultrasonic elastography（P<0.05），the specificity and accuracy of ultrasonic elastography in single diagnosis were higher than those of TI-RADS classification，but the differences were not statistically significant（P>0.05）.Conclusion：The ultrasonic elastography plus TI-RADS has a higher diagnosis value in benign and malignant thyroid nodules，it is worthy of clinical promotion.

【Key words】 Benign and malignant thyroid nodules； Ultrasonic elastography； TI-RADS

First-authors address：The 5th Peoples Hospital of Foshan City，Foshan 528211，China

doi：10.3969/j.issn.1674-4985.2018.27.016

近年來随着各种影像学方法在临床上的应用，且甲状腺检查逐步被列为体检项目，使越来越多的甲状腺结节被检出。超声诊断具有易操作、分辨率高、敏感性高等优点，逐渐成为甲状腺检查的首选手段。但灰阶超声对良恶性结节的诊断效能较低，导致在未被定性的情况下进行手术的现象较多，给患者心理、生理均带来较大痛苦。1992年，随着甲状腺影报告与数据系统（TI-RADS）的制定，超声诊断的准确性进一步提高，但其仍有一定局限性，且可行性及实用性受到质疑。超声弹性成像是近年来出现的新技术，不少学者将其应用于诊断甲状腺良恶性结节，已取得较好的效果，但最新研究发现，良恶性结节内部成分结构多变，导致诊断准确率受到影响，且操作者对色彩的判断及按压手法属于主观因素，常常会影响诊断的准确性[1]。……