ACR TI-RADS分级评分系统对甲状腺结节的诊断价值  

Diagnostic value of ACR TI-RADS grading scoring system for thyroid nodules

作　　者：卓娜[1] 段清[1] 田晶[1] 李敬 ZHUO Na;DUAN Qing;TIAN Jing;LI Jing(Department of Ultrasound,The Second Hospital of Tianjin Medical University,Tianjin 300211,China)

机构地区：[1]天津医科大学第二医院超声科,天津300211

出　　处：《天津医科大学学报》2020年第2期153-157,共5页Journal of Tianjin Medical University

摘　　要：目的:研究美国放射学会甲状腺影像报告和数据系统(ACR TI-RADS)对甲状腺结节风险的诊断价值,分析ACR TI-RADS分级对于不同大小结节(以结节大小1 cm为界)的诊断效能,以指导临床。方法:收集2018年1月至2019年1月于我院行甲状腺结节切除术患者122例,利用二维超声对其136个结节进行了ACR TI-RADS分级评分,与病理结果对照绘制ROC曲线下面积,并观察ACR TI-RADS分级的灵敏度及特异度分布,利用曲线下面积(AUC)比较超声ACR TI-RADS分级对甲状腺结节的诊断价值及对不同大小结节在诊断上的效果。结果:二维ACR TI-RADS分级评分得到的ROC曲线下面积为0.8553(0.7537,0.9141),最佳界值点为6.5。>1 cm与≤1 cm甲状腺结节间ACR TI-RADS分级评分的AUC 95%CI无交叉,因此对于>1 cm与≤1 cm结节间的ACR TI-RADS分级评分的诊断效果差异有统计学意义。结论:ACR TI-RADS分级系统对于判断甲状腺结节风险有价值,诊断的灵敏度95.3%、特异度62.7%,分级为TR5级的结节恶性风险明显增加。ACR TI-RADS分级对于直径>1 cm的甲状腺结节的诊断效能优于直径≤1 cm的结节。Objective:To study the diagnostic value of the American Radiological Society Thyroid Imaging Reporting and Data System(ACR TI-RADS)in assessing the risk of thyroid nodules,and to analyze the diagnostic efficacy of the ACR TI-RADS classification for nodules of different sizes(with a nodule size of 1cm)to guide clinical practice.Methods:122 cases of thyroid nodule resection in our hospital from January 2018 to January 2019 were collected.The 136 nodules were graded by ACR TI-RADS using two-dimensional ultrasound,and the area under ROC curve was drawn by compared with the pathological results.The sensitivity and specificity distribution of ACR TI-RADS grading were observed.The diagnostic value of ultrasonic ACR TI-RADS grading for thyroid nodules and the diagnostic effect on nodules of different size were compared by using the area under curve(AUC).Results:The area under the ROC curve obtained by the two-dimensional ACR TI-RADS classification score was 0.8553(0.7537,0.9141),and the best cut-off point was 6.5.There was no crossover between the thyroid nodule diameter>1 cm and the nodule diameter≤1 cm by ACR TI-RADS grading score AUC 95% CI,so there was a statistically significant difference in the diagnostic effect of ACR TI-RADS grading score between>1 cm and≤1 cm nodule.Conclusion:The ACR TI-RADS grading system is valuable for judging the risk of thyroid nodules.The diagnostic sensitivity is 95.3% and the specificity is 62.7%.The malignant risk of nodules classified as TR5 is significantly increased.The ACR TI-RADS classification for the diagnosis of thyroid nodule diameter>1 cm is superior to the nodule with diameter≤1 cm.

关 键 词：甲状腺影像报告和数据系统 甲状腺结节 超声造影 风险分级 

分 类 号：R445.1[医药卫生—影像医学与核医学] R581[医药卫生—诊断学]