S-Detect技术与应变弹性成像对C-TI-RADS 4A类甲状腺结节的诊断价值

郑志燕; 叶新华; 章东

doi:10.16766/j.cnki.issn.1674-4152.002994

S-Detect技术与应变弹性成像对C-TI-RADS 4A类甲状腺结节的诊断价值

doi: 10.16766/j.cnki.issn.1674-4152.002994

郑志燕^{1, 2},
叶新华^1, ,,
章东³

1.
南京医科大学第一附属医院超声医学科, 江苏南京 210029
2.
安徽医科大学附属滁州医院(滁州市第一人民医院)超声中心，安徽滁州 239000
3.
南京大学声学研究所近代声学教育部重点实验室，江苏南京 210093

基金项目:

江苏省级重点研发计划项目 BE2018703

详细信息

通讯作者:
叶新华, E-mail: yexh-0125@163.com

中图分类号: R445.1 R736.1
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- HTML全文浏览量: 107
- PDF下载量: 10
- 被引次数: 0
出版历程
- 收稿日期: 2022-09-06

Diagnosis value of S-Detect technique and strain elastography for C-TI-RADS 4A thyroid nodules

ZHENG Zhiyan^{1, 2},
YE Xinhua^{1
, ,},
ZHANG Dong³

1.
Department of Ultrasound Diagnostics, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China

摘要

摘要: 目的评估S-Detect技术与应变弹性成像对C-TI-RADS 4A类甲状腺结节的再分类，探讨二者对C-TI-RADS 4A类甲状腺结节的诊断价值。方法选取2021年4月—2022年4月在南京医科大学第一附属医院超声诊断科常规超声检查报告为C-TI-RADS 4A类且有明确病理结果的87例患者共102个结节，应用三星S-Detect技术与应变弹性成像对结节辅助诊断重新分类，比较S-Detect技术、应变弹性成像及2种方法协助人工再分类诊断结果与病理结果的一致性，以及2种方法对C-TI-RADS 4A类结节的诊断效能。结果 2种方法诊断结果与病理结果具有一致性，S-Detect技术与病理结果的一致性(Kappa=0.652，P < 0.001)高于应变弹性成像(Kappa=0.381，P < 0.001)，2种方法协助人工再分类与病理结果的一致性(Kappa=0.510，P < 0.001)介于二者之间，S-Detect技术和应变弹性成像对C-TI-RADS 4A类结节良恶性诊断的灵敏度、特异度、准确度分别为93.10%、70.45%、83.33%和62.07%、77.27%、68.63%。S-Detect技术诊断C-TI-RADS 4A类结节的灵敏度、准确度高于应变弹性成像(均P < 0.05)，而两者诊断的特异度比较差异无统计学意义(P > 0.05)。结论 S-Detect技术与应变弹性成像作为辅助性诊断方法，对C-TI-RADS 4A类结节的诊断与病理结果均具有一致性，且前者一致性高。
- 超声 /
- S-Detect /
- 应变弹性成像 /
- 甲状腺结节 /
- C-TI-RADS
Abstract: Objective Evaluate the reclassification of C-TI-RADS 4A thyroid nodules using S-Detect technology and strain elastography, and explore their diagnostic value for C-TI-RADS 4A thyroid nodules. Methods A total of 102 nodules were selected from 87 patients of C-TI-RADS 4A with clear-defined pathological results from April 2021 to April 2022 in the routine ultrasound examination of the First Affiliated Hospital of Nanjing Medical University. Samsung S-Detect technology and strain elastography were used to aid in the reclassification of nodules. The consistency between S-Detect technology, strain elastography, two methods to assist in manual reclassification diagnosis and pathological results was compared, as well as the diagnostic efficacy of the two methods for C-TI-RADS 4A type nodules. Results The diagnostic results of the two methods were consistent with the pathological results, the consistency between S-Detect technology and the pathological results (Kappa=0.652, P < 0.001) was higher than that of strain elastography (Kappa=0.381, P < 0.001), the consistency between the manual reclassification assisted by the two methods and the pathological results (Kappa=0.510, P < 0.001) was between the two methods. The sensitivity, specificity and accuracy of S-Detect technology and strain elastography for the benign and malignant diagnosis of C-TI-RADS 4A nodules were 93.10%, 70.45%, 83.33% and 62.07%, 77.27% and 68.63%, respectively. The sensitivity and accuracy of S-Detect technology in diagnosing C-TI-RADS 4A nodules was higher than that of strain elastography (all P < 0.05), however, the specificity of the two methods was not statistically significant (P > 0.05). Conclusion The S-Detect technique and strain elastography, as an assisted diagnostic method, have consistent diagnostic results of C-TI-RADS 4A type nodules with pathological results, and the S-Detect technique has high consistency.
- Ultrasound /
- S-Detect /
- Strain elastography /
- Thyroid nodules /
- C-TI-RADS
利益冲突 无

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图 1 S-Detect技术与应变弹性成像对C-TI-RADS 4A类结节的诊断与病理对照

注：A示S-Detect技术诊断为可能良性，降为3类；B示应变弹性成像评分为2分，视为良性，降为3类；C示病理结果为甲状腺乳头状癌，镜下可见核拉长、重叠、拥挤，并见核沟、核内包涵体(HE，×100)。

Figure 1. Comparison of diagnosis and pathology of C-TI-RADS 4A nodules by S-Detect and strain elastography

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图 2 S-Detect技术与应变弹性成像对C-TI-RADS 4A类结节的诊断与病理对照

注：A示S-Detect技术诊断为可能恶性，分类不变；B示应变弹性成像评分为2分，视为良性，降为3类；C示病理结果为亚急性甲状腺炎，镜下可见部分滤泡被破坏，胶质外溢，肉芽肿形成及炎细胞浸润(HE，×40)。

Figure 2. Comparison of diagnosis and pathology of C-TI-RADS 4A nodules by S-Detect and strain elastography

下载: 全尺寸图片幻灯片

表 1 不同方法诊断结果与病理结果的一致性比较

Table 1. Comparison of consistency between diagnostic results of different methods and pathological results

方法		病理结果			Kappa	P值
方法		恶性	良性	合计	Kappa	P值
S-Detect	恶性	54	13	67	0.652	< 0.001
	良性	4	31	35
	合计	58	44	102
应变弹性成像	恶性	36	10	46	0.381	< 0.001
	良性	22	34	56
	合计	58	44	102
人工再分类	恶性	34	2	36	0.510	< 0.001
	良性	24	42	66
	合计	58	44	102

下载: 导出CSV

表 2 S-Detect技术与应变弹性成像对C-TI-RADS 4A类结节诊断效能分析

Table 2. Analysis of diagnostic efficacy of S-Detect technology and strain elastography for C-TI-RADS 4A nodules

方法	灵敏度(%)		特异度(%)		准确度(%)
方法	数值	95% CI	数值	95% CI	数值	95% CI
S-Detect	93.10	82.45~97.77	70.45	54.61~82.75	83.33	74.66~89.98
应变弹性成像	62.07	48.35~74.19	77.27	61.78~88.01	68.63	58.69~77.45
χ²值	13.136		0.211		5.488
P值	< 0.001		0.648		0.028

下载: 导出CSV

参考文献(18)

[1]	尹嘉晶, 王任飞, 曲伸. 真实世界甲状腺癌的诊疗现状与思考[J]. 中国实用内科杂志, 2022, 42(11): 915-919. https://www.cnki.com.cn/Article/CJFDTOTAL-SYNK202211009.htm YIN J J, WANG R F, QU S. Current situation and thinking on diagnosis and treatment of thyroid cancer in the real world[J]. Chinese Journal of Practical Internal Medicine, 2022, 42(11): 915-919. https://www.cnki.com.cn/Article/CJFDTOTAL-SYNK202211009.htm
[2]	ZHOU J Q, YIN L X, WEI X, et al. 2020 Chinese guidelines for Ultrasound malignancy risk stratification of thyroid nodules the C-TIRADS[J]. Endocrine, 2020, 70(2): 256-279. doi: 10.1007/s12020-020-02441-y
[3]	周一帆, 王建华, 徐书杭. 甲状腺细胞病理学Bethesda报告系统的更新及研究进展[J]. 国际内分泌代谢杂志, 2020, 40(3): 175-178. ZHOY Y F, WANG J H, XU S H. Update and research progress of Bethesda reporting system of thyroid cell pathology[J]. International Journal of Endocrinology and Metabolism, 2020, 40(3): 175-178.
[4]	LIN Z M, WEN Q, YAN C X, et al. Combination of contrast enhanced ultrasound and strain elastography to assess cytologically non diagnostic thyroid nodules[J]. Oncol Lett, 2019, 18(6): 6845-6851.
[5]	吴丽露, 徐芳婷, 孙杨, 等. 常规超声及应变弹性成像对细胞学结果不确定甲状腺结节的诊断价值[J]. 临床超声医学杂志, 2019, 21(12): 886-890. https://www.cnki.com.cn/Article/CJFDTOTAL-LCCY201912003.htm WU L L, XU F T, SUN Y, et al. Diagnostic value of conventional ultrasound and strain elastography in thyroid nodules with uncertain cytological results[J]. Journal of Clinical Ultrasound Medicine, 2019, 21(12): 886-890. https://www.cnki.com.cn/Article/CJFDTOTAL-LCCY201912003.htm
[6]	杜建文, 葛雪, 刘欢颜, 等. S-Detect技术与BI-RADS分类对乳腺肿物良恶性评估的比较[J]. 中国超声医学杂志, 2019, 35(7): 580-583. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCY201907002.htm DU J W, GE X, LIU H Y, et al. Comparison between S-Detect and BI-RADS in the evaluation of benign and malignant breast tumors[J]. Chinese Journal of Ultrasound Medicine, 2019, 35(7): 580-583. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCY201907002.htm
[7]	LI J, TIAN S, YU W H, et al. The value of S-Detect for the differential diagnosis of breast masses on ultrasound: a systematic review and pooled meta-analysis[J]. Med Ultrason, 2020, 22(2): 211-219. doi: 10.11152/mu-2402
[8]	LI X C, ZHANG S, ZHANG Q, et al. Diagnosis of thyroid cancer using deep convolutional neural network models aplied to sonographic images: a retrospective, multicohort, diagnostic study[J]. Lancet Oncol, 2019, 20(2): 193-201. doi: 10.1016/S1470-2045(18)30762-9
[9]	程若川, 杨婷婷. 2016版中国甲状腺微小乳头状癌诊断与治疗中国专家共识解读[J]. 中国实用内科杂志, 2019, 39(4): 351-357. https://www.cnki.com.cn/Article/CJFDTOTAL-SYNK201904012.htm CHENG R C, YANG T T. 2016 Edition Interpretation of Chinese Expert Consensus on Diagnosis and Treatment of Thyroid Micropapillary Carcinoma[J]. Chinese Journal of Practical Internal Medicine, 2019, 39(4): 351-357. https://www.cnki.com.cn/Article/CJFDTOTAL-SYNK201904012.htm
[10]	戴旭. 甲状腺微小乳头状癌的诊疗过度与不足: 基于专家共识的再思考[J]. 医学与哲学, 2019, 40(16): 31-34. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZX201916009.htm DAI X. Excessive and insufficient diagnosis and treatment of thyroid micropapillary carcinoma: rethinking based on expert consensus[J]. Medicine and Philosophy, 2019, 40(16): 31-34. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZX201916009.htm
[11]	彭光生, 陈怡. 甲状腺结节过度超声诊断及应对策略[J]. 中国超声医学杂志, 2020, 36(10): 883-886. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCY202010006.htm PENG G S, CHEN Y. Diagnosis and coping strategies of thyroid nodule by ultrasonography[J]. Chinese Journal of Ultrasound Medicine, 2020, 36(10): 883-886. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCY202010006.htm
[12]	CANTISANI V, SILVESTRI A D, SCOTTI V, et al. US-Elastography with different techniques for thyroid nodule characterization: systematic review and meta-analysis[J]. Front Oncol, 2022, 12(3): 845549. DOI: 10.3389/fonc.2022.845549.
[13]	陈晨, 孙鹏飞, 郭君, 等. 人工智能在甲状腺结节良恶性中的诊断价值[J]. 中国超声医学杂志, 2020, 36(7): 585-588. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCY202007004.htm CHEN C, SUN P F, GUO J, et al. Diagnostic value of artificial intelligence in benign and malignant thyroid nodules[J]. Chinese Journal of Ultrasound Medicine, 2020, 36(7): 585-588. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCY202007004.htm
[14]	郭斌, 陈蕊, 王圣应, 等. 208例甲状腺乳头状癌患者颈部淋巴结转移相关因素分析[J]. 中华全科医学, 2022, 20(2): 195-198. doi: 10.16766/j.cnki.issn.1674-4152.002310 GUO B, CHEN R, WANG S Y, et al. Analysis of related factors of cervical lymph node metastasis in 208 patients with thyroid papillary carcinoma[J]. Chinese General Practice, 2022, 20(2): 195-198. doi: 10.16766/j.cnki.issn.1674-4152.002310
[15]	高红燕, 詹小林, 陈冬冬, 等. 超声C-TIRADS联合应变弹性成像在C-TIRADS 4类甲状腺结节良恶性评估中的应用价值[J]. 安徽医学, 2022, 43(9): 999-1003. https://www.cnki.com.cn/Article/CJFDTOTAL-AHYX202209002.htm GAO H Y, ZHAN X L, CHEN D D, et al. The application value of ultrasonic C-TIRADS combined with strain elastography in the evaluation of benign and malignant C-TIRADS type 4 thyroid nodules[J]. Anhui Medical Journal, 2022, 43(9): 999-1003. https://www.cnki.com.cn/Article/CJFDTOTAL-AHYX202209002.htm
[16]	徐锦媚, 刘萌, 王鑫毅, 等. 计算机辅助诊断系统联合弹性成像及高年资超声医师判读鉴别甲状腺结节良恶性的价值[J]. 临床超声医学杂志, 2022, 12(3): 26-30. https://www.cnki.com.cn/Article/CJFDTOTAL-LCCY202201005.htm XU J M, LIU M, WANG X Y, et al. The value of computer aided diagnosis system combined with elastography and senior ultrasonic physicians in differentiating benign and malignant thyroid nodules[J]. Journal of Clinical Ultrasound Medicine, 2022, 12(3): 26-30. https://www.cnki.com.cn/Article/CJFDTOTAL-LCCY202201005.htm
[17]	XIA S J, YAO J J, ZHOU W, et al. A computer-aided diagnosing system in the evaluation of thyroid nodules-experience in a specialized thyroid center[J]. World J Surg Oncol, 2019, 17(1): 210-217.
[18]	李潜, 丁思悦, 郭兰伟, 等. 甲状腺结节超声恶性危险分层中国指南(C-TIRADS)联合人工智能辅助诊断对甲状腺结节鉴别诊断的效能评估[J]. 中华超声影像学杂志, 2021, 30(3): 231-235. LI Q, DING S Y, GUO L W, et al. Evaluation of the efficacy of the Chinese guidelines for ultrasonic malignant risk stratification of thyroid nodules (C-TIRADS) combined with artificial intelligence in the differential diagnosis of thyroid nodules[J]. Chinese Journal of Ultrasound Imaging, 2021, 30(3): 231-235.