微创医学

目的探讨超声甲状腺影像报告和数据系统（TI-RADS）在桥本氏甲状腺炎合并微小癌中的诊断价值。方法162例甲状腺结节患者，采用超声TI-RADS进行诊断。以病理组织学结论作为金标准，评估TI-RADS诊断甲状腺疾病的可行性和准确性。结果162例甲状腺结节经病理组织学证实均为桥本氏甲状腺炎。276个甲状腺结节按TI-RADS分类，其中Ⅱ类、Ⅲ类、Ⅳ类、Ⅴ类的恶性符合率分别为1.0%、4.0%、82.0%、100.0%；以Ⅳa类作为良恶性交界的分水岭，良性分类(Ⅱ类、Ⅲ类)与恶性分类( Ⅳb类、Ⅴ类)具有显著差异。TI-RADS分类诊断良恶性结节的灵敏度、特异性、符合率分别为69.0%、96.0%、89.0%。结论深入研究甲状腺结节的超声影像与病理特征，有助于提高甲状腺TI-RADS分类对桥本氏甲状腺炎背景下结节良恶性的判断，为临床诊疗方案提供更好的指导作用。

ObjectiveTo evaluate the diagnosis value of ultrasonographic thyroid imaging-reporting and data system (TI-RADS) in Hashimoto′s thyroiditis complicated with thyroid micro carcinoma. MethodsA total of 162 cases with thyroid nodule were diagnosed with ultrasonographic TI-RADS. Using the pathological results as the golden standard, the feasibility and accuracy of ultrasonographic TI-RADS were assessed. ResultsAll of the 162 cases of Hashimoto′s thyroiditis thyroid nodule were confirmed by pathology. 276 thyroid nodules were classified according to TI-RADS, and the malignant coincidence rate of class II, III, IV and V was 1.0%, 4.0%, 82.0% and 100.0%, respectively. There were statistically significant differences between benign classifications(level II、III) and malignant classifications（level IVb、V）which conducted level IVa artificially as the demarcation between normality and malignancy. The sensitivity, specificity and coincidence in diagnosing benign and malignant thyroid nodule with ultrasonographic TI-RADS was 69.0%、96.0% and 89.0%, separately. ConclusionsTo study the ultrasonography and pathology of the thyroid nodule more thoroughly is helpful in improving the accuracy in differentiating benign and malignant thyroid nodule under the background of Hashimoto′s thyroiditis with ultrasonographic classification with TI-RADS, which is more practical for clinical diagnosis and treatment.