{"title":"c-tirads壳体技术结合超声诊断4-5级c-tirads结节的应用。","authors":"Bi-Yun Sun, Wei Peng","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To analyze the diagnostic value of the Shell technique in the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) combined with Shear Wave Elastography (STE) for differentiating benign and malignant C-TIRADS grade 4-5 nodules.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 279 patients (with a total of 286 C-TIRADS grade 4-5 nodules) who underwent thyroid fine-needle aspiration biopsy (FNA) or surgery. Nodules were differentiated as benign or malignant using C-TIRADS classification, STE, and their combination. Taking cytopathological or postoperative pathological diagnosis as the gold standard, Receiver Operating Characteristic (ROC) curves were plotted, and the Area Under the Curve (AUC), sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were calculated to compare the diagnostic efficacy.</p><p><strong>Results: </strong>Pathological results showed that among 286 nodules, 94 were benign and 192 were malignant. C-TIRADS diagnosed 122 benign and 164 malignant nodules; STE diagnosed 115 benign and 171 malignant nodules; the combination diagnosed 108 benign and 178 malignant nodules. The AUC of the combined diagnosis for C-TIRADS grade 4-5 nodules was significantly larger than that of C-TIRADS classification and STE alone (Z=5.195, P<0.001; Z=3.602, P<0.001). The sensitivity of the combined diagnosis was higher than that of C-TIRADS classification and STE alone (χ²=8.649, P=0.003; χ²=5.488, P=0.019). The accuracy of the combined diagnosis was higher than that of C-TIRADS classification and STE alone (χ²=11.457, P<0.001; χ²=9.527, P=0.002). The NPV of the combined diagnosis was higher than that of C-TIRADS classification and STE alone (χ²=6.685, P=0.010; χ²=4.997, P=0.025).</p><p><strong>Conclusion: </strong>Compared with single application, C-TIRADS combined with the Shell technique in STE significantly improves the diagnostic sensitivity, accuracy, and NPV for C-TIRADS grade 4-5 thyroid nodules, demonstrating certain clinical application value.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 363","pages":"18-22"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"APPLICATION OF SHELL TECHNIQUE IN C-TIRADS COMBINED WITH STE IN DIAGNOSIS OF C-TIRADS GRADE 4-5 NODULES.\",\"authors\":\"Bi-Yun Sun, Wei Peng\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To analyze the diagnostic value of the Shell technique in the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) combined with Shear Wave Elastography (STE) for differentiating benign and malignant C-TIRADS grade 4-5 nodules.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 279 patients (with a total of 286 C-TIRADS grade 4-5 nodules) who underwent thyroid fine-needle aspiration biopsy (FNA) or surgery. Nodules were differentiated as benign or malignant using C-TIRADS classification, STE, and their combination. Taking cytopathological or postoperative pathological diagnosis as the gold standard, Receiver Operating Characteristic (ROC) curves were plotted, and the Area Under the Curve (AUC), sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were calculated to compare the diagnostic efficacy.</p><p><strong>Results: </strong>Pathological results showed that among 286 nodules, 94 were benign and 192 were malignant. C-TIRADS diagnosed 122 benign and 164 malignant nodules; STE diagnosed 115 benign and 171 malignant nodules; the combination diagnosed 108 benign and 178 malignant nodules. The AUC of the combined diagnosis for C-TIRADS grade 4-5 nodules was significantly larger than that of C-TIRADS classification and STE alone (Z=5.195, P<0.001; Z=3.602, P<0.001). The sensitivity of the combined diagnosis was higher than that of C-TIRADS classification and STE alone (χ²=8.649, P=0.003; χ²=5.488, P=0.019). The accuracy of the combined diagnosis was higher than that of C-TIRADS classification and STE alone (χ²=11.457, P<0.001; χ²=9.527, P=0.002). The NPV of the combined diagnosis was higher than that of C-TIRADS classification and STE alone (χ²=6.685, P=0.010; χ²=4.997, P=0.025).</p><p><strong>Conclusion: </strong>Compared with single application, C-TIRADS combined with the Shell technique in STE significantly improves the diagnostic sensitivity, accuracy, and NPV for C-TIRADS grade 4-5 thyroid nodules, demonstrating certain clinical application value.</p>\",\"PeriodicalId\":12610,\"journal\":{\"name\":\"Georgian medical news\",\"volume\":\" 363\",\"pages\":\"18-22\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Georgian medical news\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Georgian medical news","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的：分析Shell技术在中国甲状腺影像报告资料系统（C-TIRADS）联合横波弹性成像（STE）中鉴别C-TIRADS良恶性4-5级结节的诊断价值。方法：对279例（共286例C-TIRADS分级4-5结节）行甲状腺细针穿刺活检（FNA）或手术的患者进行回顾性分析。采用C-TIRADS分级、STE及两者结合的方法对结节进行良恶性鉴别。以细胞病理学或术后病理诊断为金标准，绘制受试者工作特征（Receiver Operating Characteristic， ROC）曲线，计算曲线下面积（Area Under the Curve， AUC）、敏感性、特异性、准确性、阳性预测值（positive predictive value， PPV）、阴性预测值（negative predictive value， NPV），比较诊断效果。结果：病理结果显示，286例结节中，良性94例，恶性192例。C-TIRADS诊断良性结节122例，恶性结节164例；STE诊断良性结节115例，恶性结节171例；联合诊断出108个良性结节和178个恶性结节。C-TIRADS分级4-5级甲状腺结节联合诊断的AUC明显大于C-TIRADS分级和STE单独诊断的AUC （Z=5.195, p）。结论：与单独应用相比，C-TIRADS联合Shell技术在STE诊断中可显著提高C-TIRADS分级4-5级甲状腺结节的诊断敏感性、准确性和NPV，具有一定的临床应用价值。
APPLICATION OF SHELL TECHNIQUE IN C-TIRADS COMBINED WITH STE IN DIAGNOSIS OF C-TIRADS GRADE 4-5 NODULES.
Objective: To analyze the diagnostic value of the Shell technique in the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) combined with Shear Wave Elastography (STE) for differentiating benign and malignant C-TIRADS grade 4-5 nodules.
Methods: A retrospective analysis was performed on 279 patients (with a total of 286 C-TIRADS grade 4-5 nodules) who underwent thyroid fine-needle aspiration biopsy (FNA) or surgery. Nodules were differentiated as benign or malignant using C-TIRADS classification, STE, and their combination. Taking cytopathological or postoperative pathological diagnosis as the gold standard, Receiver Operating Characteristic (ROC) curves were plotted, and the Area Under the Curve (AUC), sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were calculated to compare the diagnostic efficacy.
Results: Pathological results showed that among 286 nodules, 94 were benign and 192 were malignant. C-TIRADS diagnosed 122 benign and 164 malignant nodules; STE diagnosed 115 benign and 171 malignant nodules; the combination diagnosed 108 benign and 178 malignant nodules. The AUC of the combined diagnosis for C-TIRADS grade 4-5 nodules was significantly larger than that of C-TIRADS classification and STE alone (Z=5.195, P<0.001; Z=3.602, P<0.001). The sensitivity of the combined diagnosis was higher than that of C-TIRADS classification and STE alone (χ²=8.649, P=0.003; χ²=5.488, P=0.019). The accuracy of the combined diagnosis was higher than that of C-TIRADS classification and STE alone (χ²=11.457, P<0.001; χ²=9.527, P=0.002). The NPV of the combined diagnosis was higher than that of C-TIRADS classification and STE alone (χ²=6.685, P=0.010; χ²=4.997, P=0.025).
Conclusion: Compared with single application, C-TIRADS combined with the Shell technique in STE significantly improves the diagnostic sensitivity, accuracy, and NPV for C-TIRADS grade 4-5 thyroid nodules, demonstrating certain clinical application value.
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