两种甲状腺超声数据报告系统诊断效能的比较  

Comparison of diagnostic efficacy of two kinds of thyroid imagine reporting and data systems

作　　者：肖娟[1] 肖强 丛伟[3] 李婷 丁守銮 张媛[1] 邵纯纯 吴梅[4] 刘佳宁[3] 贾红英[1] XIAO Juan;XIAO Qiang;CONG Wei;LI Ting;DING Shouluan;ZHANG Yuan;SHAO Chunchun;WU Mei;LIU Jianing;JIA Hongying(Center of Evidence-Based Medicine,Institute of Medical Sciences,The Second Hospital,Cheeloo College of Medicine,Shandong University,Jinan 250033,Shandong,China;Department of Biostatistics,School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan 250012,Shandong,China;Department of Thyroid Surgery,The Second Hospital,Cheeloo College of Medicine,Shandong University,Jinan 250033,Shandong,China;Center of Ultrasonography,Department of Medical Imaging,The Second Hospital,Cheeloo College of Medicine,Shandong University,Jinan 250033,Shandong,China)

机构地区：[1]山东大学第二医院基础医学研究所/循证医学中心,山东济南250033 [2]山东大学公共卫生学院生物统计系,山东济南250012 [3]山东大学第二医院甲状腺外科,山东济南250033 [4]山东大学第二医院医学影像中心超声科,山东济南250033

出　　处：《山东大学学报（医学版）》2020年第7期53-59,共7页Journal of Shandong University:Health Sciences

基　　金：山东大学教育教学改革重点项目(2019Z10)。

摘　　要：目的比较Kwak与ACR(2017)两种甲状腺影像报告和数据系统(TI-RADS)的诊断效能。方法回顾性收集2017年3月至2019年4月于山东大学第二医院行手术治疗的792例甲状腺结节患者资料,以1940个甲状腺结节为研究对象开展研究。由2名从事甲状腺超声专业的高年资医师,分别采用两种TI-RADS评估标准对结节进行回顾性判读并进行统计学评价和比较。结果Kwak TI-RADS最佳诊断分界点为≥4a级,其灵敏度、特异度分别为82.71%、76.06%;ACR(2017)TI-RADS最佳诊断分界点为TR5级,其灵敏度、特异度分别为68.67%、85.46%。Kwak TI-RADS的灵敏度高于ACR(2017)TI-RADS(P<0.001),而ACR(2017)TI-RADS的特异度高于Kwak TI-RADS(P<0.001)。Kwak TI-RADS的受试者工作曲线下面积(AUC)为0.826,高于ACR(2017)TI-RADS的0.810(P=0.024)。在≥1 cm结节中,两种TI-RADS体系的AUC差异无统计学意义(P=0.918);在<1 cm结节中,两种TI-RADS体系的AUC均较低,且Kwak高于ACR(2017)(P<0.001)。结论Kwak TI-RADS诊断效能略优于ACR(2017)TI-RADS,Kwak TI-RADS的灵敏度较高,而ACR(2017)TI-RADS的特异度较高。Objective To compare the diagnostic efficacy of Kwak and ACR(2017)thyroid imaging reporting and data system(TI-RADS).Methods Data of 792 patients with thyroid nodules who underwent surgery during March 2017 and April 2019 were retrospectively collected and 1940 thyroid nodules were enrolled.Imaging features of thyroid nodules were analyzed by two senior qualified sonographers using Kwak and ACR(2017)TI-RADS.Results The best diagnostic cut-off point of Kwak TI-RADS was≥4 a,and the sensitivity and specificity was 82.71%and 76.06%,respectively.The best diagnostic cut-off point of ACR(2017)TI-RADS was TR5,and the sensitivity and specificity was 68.67%and 85.46%,respectively.The sensitivity of Kwak TI-RADS was higher than that of ACR(2017)TI-RADS(P<0.001)while the specificity of ACR(2017)TI-RADS was higher than that of Kwak TI-RADS(P<0.001).The area under the receiver operating characteristic curve(AUC)of Kwak TI-RADS was 0.826,which was higher than that of ACR(2017)TI-RADS(0.810,P=0.024).Both Kwak and ACR(2017)TI-RADS yielded relatively higher overall diagnostic efficacy in nodules≥1 cm than in nodules<1 cm(P=0.918).In nodules<1 cm,Kwak TI-RADS did better than ACR(2017)TI-RADS(P<0.001).Conclusion The overall diagnostic efficacy of Kwak TI-RADS is slightly higher than that of ACR(2017)TI-RADS.Kwak TI-RADS has better performance in sensitivity while ACR(2017)TI-RADS does better in specificity.

关 键 词：甲状腺影像报告和数据系统 Kwak TI-RADS ACR(2017)TI-RADS 诊断效能 

分 类 号：R445.1[医药卫生—影像医学与核医学]