远红外联合超声C-TIRADS对甲状腺结节良恶性诊断
Far Infrared Combined with Ultrasound C-TIRADS for the Diagnosis of Benign and Malignant Thyroid Nodules

目的：探讨利用远红外热成像(far infrared thermal imaging, FITI)联合中国版甲状腺影像报告和数据系统(C-TIRADS)对于甲状腺结节良恶性鉴别结果及准确性分析。方法：选择114例接受甲状腺手术或超声引导下细针穿刺的患者，术前留取FITI、超声C-TIRADS报告，分析单应用及联合应用对诊断甲状腺结节的良恶性诊断效能。结果：在114例病例中，良性结节53例(46.5%)，其中单纯性甲状腺肿37例，腺瘤9例，囊性肿物6例；恶性结节61例(53.5%)，其中乳头状癌60例(98.4%)，未分化癌1例(1.6%)。单纯C-TIRADS及FITI的灵敏度、特异度、准确度分别为62.30%，86.79%，73.7%和73.77%，71.70%，72.8%。联合诊断灵敏度、特异度、准确度分别为80.33%，92.45%，86.0%，C-TIRADS、FITI、联合诊断的AUC曲线下面积分别0.745，0.727，0.864。C-TIRADS和FITI对比联合诊断P < 0.05，具有显著差异。结论：C-TIRADS和FITI联合诊断对比单独超声C-TIRADS和FITI可显著提高诊断甲状腺恶性结节的效能。
Objective: To explore the use of far infrared thermal imaging (FITI) combined with the Chinese version of the thyroid imaging report and data system (C-TIRADS) for the differentiation of benign and malignant thyroid nodules and its accuracy analysis. Method: 114 patients who underwent thyroid surgery or ultrasound-guided fine-needle aspiration were selected. FITI and ultrasound C-TIRADS reports were collected before surgery, and the diagnostic efficacy of single and combined use in the diagnosis of benign and malignant thyroid nodules was analyzed. Results: Among 114 cases, 53 were benign nodules (46.5%), including 37 cases of simple goiter, 9 cases of adenoma, and 6 cases of cystic mass; there were 61 cases (53.5%) of malignant nodules, including 60 cases (98.4%) of papillary carcinoma and 1 case (1.6%) of undifferentiated carcinoma. The sensitivity, specificity, and accuracy of C-TIRADS and FITI alone were 62.30%, 86.79%, 73.7%, and 73.77%, 71.70%, and 72.8%, respectively. The sensitivity, specificity, and accuracy of combined diagnosis were 80.33%, 92.45%, and 86.0%, respectively. The area under the AUC curve for C-TIRADS, FITI, and combined diagnosis was 0.745, 0.727, and 0.864, respectively. The combined diagnosis of C-TIRADS and FITI showed a significant difference (P < 0.05). Conclusion: The combination of C-TIRADS and FITI can significantly improve the diagnostic efficacy of thyroid malignant nodules compared to ultrasound alone.