改良甲状腺影像学报告及数据系统（TI-RADS）分级诊断甲状腺癌的可行性研究  

The application value of improved thyroid imaging report and data system （TI-RADS） in diagnosing thyroid cancers：a polit study

作　　者：都莹[1] 田家玮[1] 刘微[1] 刘铭[1] 刘路颖 邹颖[1] 王星[1] 宫兆珏 

机构地区：[1]哈尔滨医科大学附属第二医院超声医学科,150086

出　　处：《中华超声影像学杂志》2015年第10期878-881,共4页Chinese Journal of Ultrasonography

基　　金：基金项目：黑龙江省卫生厅科研课题（2013312）

摘　　要：目的探讨改良甲状腺影像学报告及数据系统（TI-RADS）对甲状腺癌的诊断价值。方法回顾分析792例甲状腺结节的超声图像，应用传统TI-RADS对结节进行分级；通过对甲状腺结节的二维、彩色以及弹性特征评分，获得超声综合评分，依据此评分对TI-RADS改良，再应用改良系统对同样792例结节进行重新分级。应用组内相关系数（ICC）分析高年资与低年资医生对甲状腺结节分级的相关性。结果①792个结节包括良性438个（55．3％）和恶性结节354个（44．7％）；②ROC曲线分析：超声综合评分对甲状腺良恶性结节鉴别诊断的曲线下面积为0．922，当截断值为9．5分，诊断甲状腺癌的敏感性为88．42％，特异性为84．14％；③改良TI-RADS分级对4级结节恶性风险评估较传统TI-RADS准确；④高年资与低年资医生对传统TI-RADS分级ICC为0．905，对改良TI-RADS分级的ICC为0．975。结论改良TI-RADS分级可作为有效鉴别甲状腺良恶性结节的量化分级方法。Objective To evaluate the diagnostic value of improved thyroid imaging report and data system （TI-RADS） in the diagnosis of thyroid cancer. Methods A retrospective analysis of 792 cases of thyroid nodules with ultrasound images was performed. The traditional TI-RADS was applied to grade the thyroid nodules. Based on the ultrasonic score, which was obtained by the two-dimensional ultrasound, color Doppler sonography and elastography of thyroid nodules, the improved TI-RADS was established, and then applied to evaluate the same 792 cases of nodules. The intraclass correlation coefficient （ICC） was used to analyze the correlation in throid nodule grades from senior and junior doctors. Results （1）Seven hundred and ninty-two nodules consisted of 438 benign （55.3%） and malignant nodules 354 （44.7%）. （2）ROC curve analysis showed that the area under curve in diagnosing benign and malignant thyroid nodules by ultrasonic comprehensive score was 0.922. When the cutoff value was 9.5, the sensitivity and specificity in diagnosing thyroid cancer was 88.42% and 84.14%, respectively. （3） The improved TI-RADS was more acurrate than the traditional TI-RADS in grading 4 malignant nodules risk assessment. （4） The ICC between senior and junior doctors for thyroid nodules was 0.905 by the traditional TI-RADS, while the ICC was 0.975 by the improved TI-RADS. Conclusions The improved TI-RADS classification can be used as an effective method for the differential diagnosis of benign and malignant thyroid nodules.

关 键 词：超声检查 甲状腺肿瘤 甲状腺影像学报告及数据系统 

分 类 号：R736.1[医药卫生—肿瘤]