一个实用的CEUS TI-RADS参考ACR TI-RADS (2017) 甲状腺结节的得分和分级
Shuxian Xu1, Shuang Liang1, Honghui Su2
1Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong Province, China.
Ultrasound in medicine & biology
|May 25, 2025
概括
一个新的对比增强超声波甲状腺成像报告和数据系统 (CEUS TI-RADS) 提高了甲状腺结节的诊断准确性. 与现有的ACR TI-RADS相比,该系统可以减少不必要的细针吸收 (FNA) 活检.
科学领域:
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
- 医疗成像医学成像
背景情况:
- 甲状腺结节很常见,需要准确的诊断方法来区分良性和恶性.
- 目前的基于超声波的风险分层系统,如ACR TI-RADS,在诊断有效性方面存在局限性.
- 尽量减少不必要的细针吸收 (FNA) 对于减少患者负担和医疗保健成本至关重要.
研究的目的:
- 开发一种新的对比增强超声波甲状腺成像报告和数据系统 (CEUS TI-RADS).
- 将CEUS功能集成到现有的ACR TI-RADS框架中,而不会改变传统的超声波评分.
- 为了提高甲状腺结节的诊断性能,并减少不必要的FNA程序.
主要方法:
- 对1275名患有1521个甲状腺结节的患者进行了回顾性分析,这些患者接受了传统的超声波,CEUS和FNA.
- 后勤回归分析确定了重要的CEUS特征 (动脉相强度,冲洗速度,环增强,增强方向) 作为独立的风险因素.
- 一个CEUS TI-RADS被构建并与ACR TI-RADS对诊断疗效和活检减少进行验证.
主要成果:
- 与ACR TI-RADS相比,CEUS TI-RADS在培训,内部和外部验证队列中显示出更高的诊断效果 (AUC 0.94-0.92与0.92-0.80).
- 在培训队伍中,CEUS TI-RADS显著降低了不必要的活检率 (UBR) 到43%,而ACR TI-RADS则为59%.
- 关键的CEUS特征被确定为甲状腺结节中恶性瘤的独立预测因素.
结论:
- 开发的CEUS TI-RADS是一种简单有效的甲状腺结节差异诊断工具.
- 它保持了传统超声波评分的完整性,同时提高了诊断准确性.
- 与ACR TI-RADS相比,CEUS TI-RADS可以大幅降低不必要的FNA费率.
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