超微血管成像在TI-RADS 4类甲状腺微小结节中的诊断价值

陶迅; 李翀; 张超学

doi:10.19732/j.cnki.2096-6210.2021.05.010

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超微血管成像在TI-RADS 4类甲状腺微小结节中的诊断价值

论著 | 更新时间：2025-12-15

- 超微血管成像在TI-RADS 4类甲状腺微小结节中的诊断价值
- The value of superb micro-vascular imaging in diagnosis of TI-RADS 4 thyroid micronodules
- 肿瘤影像学 2021年30卷第5期页码：382-386
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- DOI：10.19732/j.cnki.2096-6210.2021.05.010
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- 网络出版：2021-10-28，
  
  纸质出版：2021-10-28
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陶迅,李翀,张超学. 超微血管成像在TI-RADS 4类甲状腺微小结节中的诊断价值[J]. 肿瘤影像学, 2021, 30(5): 382-386 https://doi.

org/10.19732/j.cnki.2096-6210.2021.05.010
陶迅,李翀,张超学. 超微血管成像在TI-RADS 4类甲状腺微小结节中的诊断价值[J]. 肿瘤影像学, 2021, 30(5): 382-386 https://doi. DOI： 10.19732/j.cnki.2096-6210.2021.05.010.

org/10.19732/j.cnki.2096-6210.2021.05.010 DOI：

摘要

目的：

探讨超微血管成像（superb micro-vascular imaging，SMI）技术对甲状腺影像报告和数据系统（Thyroid Imaging Reporting and Data System，TI-RADS）4类微小结节良恶性的鉴别诊断价值。

方法：

选择2019年4月2020年2月安徽医科大学第一附属医院收治的98例TI-RADS 4类甲状腺结节患者，共计99个甲状腺实性结节。术前均行SMI检查，观察、分析结节内血流特点并依据Alder血流分级和结节内外血流特点分型。所有甲状腺结节均经手术后病理学检查证实。利用受试者工作特征（receiver operating characteristic，ROC）曲线比较两种血流分型结果对甲状腺微小结节良恶性鉴别是否存在价值，并且计算两者诊断甲状腺癌的灵敏度、特异度、阳性预测值、阴性预测值。

结果：

共有甲状腺结节99个，其中良性结节52例，恶性结节47例。SMI评价的甲状腺恶性结节Alder血流分级和结节血流特点分型明显高于甲状腺良性结节，差异有统计学意义（

=8.69、

=37.5，

＜0.05）。以Alder血流分级和结节血流特点分型诊断甲状腺癌的曲线下面积（area under curve，AUC）分别为0.596、0.778，差异有统计学意义（

=2.135，

＜0.05）。两种方法诊断甲状腺癌的灵敏度、特异度、阳性预测值、阴性预测值分别为68.09%、61.54%、61.54%、68.09%及76.60%、84.91%、81.82%、80.36%。

结论：

SMI在对TI-RADS 4类微小甲状腺结节的良恶性鉴别诊断上具有一定价值，且SMI条件下结节内血流为主（Ⅲ型）与Alder血流分级在诊断甲状腺癌上存在差异。

Abstract

Objective:

To investigate the diagnostic value of superb micro-vascular imaging (SMI) in differentiating benign from malignant Thyroid Imaging Reporting and Data System (TI-RADS) 4 thyroid

micronodules.

Methods:

A total of 98 TI-RADS 4 thyroid nodules patients admitted to The First Affiliated Hospital of AnHui Medical University from April 2019 to February 2020 were selected

and there were 99 thyroid nodules. Preoperative SMI examination was performed to observe and analyze the characteristics of blood flow in the nodules and classify them according to the Alder blood flow classification and the characteristics of blood flow in the nodules. All thyroid nodules were confirmed by surgery and pathology. Receiver operating characteristic (ROC) curve was used to compare the value of the two blood flow typing results in the differential diagnosis of benign and malignant thyroid nodules

and the sensitivity

specificity

positive prediction rate and negative prediction rate of thyroid nodules were calculated.

Results:

There were 99 thyroid nodules

including 52 benign nodules and 47 malignant nodules. SMI evaluation of malignant thyroid nodules by Alder blood flow classification and nodules blood flow characteristics of parting obviously higher than that of benign thyroid nodules

the difference was statistically significant (

=8.69

=37.5;

＜0.05). The area under curve (AUC) for diagnosis of thyroid cancer based on Alder blood flow classification and nodular blood flow characteristics were 0.596

0.778 and the difference is statistically significant (

=2.135

＜0.05). The sensitivity

specificity

positive prediction rate and negative prediction rate of thyroid cancer were 68.09%

61.54%

68.09% and 76.60%

84.91%

81.82%

80.36%.

Conclusion:

SMI is of certain value in thedifferential diagnosis of benign and malignant micro-thyroid nodules in TI-RADS 4

and there is a ifference in the diagnosis of thyroid cancer between the nodule blood flow dominated (type Ⅲ) and Alder blood flow grading under the condition of SMI.

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