计算机辅助诊断系统基于不同指南诊断甲状腺良恶性结节的对比分析  

Comparative analysis of computer-aided diagnosis system in the diagnosis of benign and malignant thyroid nodules based on different guidelines

作　　者：叶冯颖 李尚青 苏淇琛[1] 游剑虹[2] 王康健 蔡名利 吕国荣[1] YE Fengying;LI Shangqing;SU Qichen;YOU Jianhong;WANG Kangjian;CAI Mingli;LV Guorong(Department of Ultrasound,the Second Affiliated Hospital of Fujian Medical University,Fujian 362000,China)

机构地区：[1]福建医科大学附属第二医院超声科,福建省泉州市362000 [2]厦门大学附属中山医院超声科 [3]福建医科大学附属漳州市医院超声科,福建省泉州市362000 [4]晋江市医院超声科

出　　处：《临床超声医学杂志》2020年第9期694-696,共3页Journal of Clinical Ultrasound in Medicine

基　　金：泉州市科技计划项目(2019C076R);教育部泉州医学高等专科学校母婴健康服务应用技术协同创新中心经费资助项目[闽科教(2017)49号];福建省临床重点专科建设项目经费资助项目[闽卫医政函(2017)739号]。

摘　　要：目的对比分析计算机辅助诊断(CAD)系统基于不同指南诊断甲状腺良恶性结节的价值。方法多中心、前瞻性分析经手术或超声引导下细针穿刺病理证实的453例甲状腺结节患者(共521个甲状腺结节),以病理结果为金标准,绘制CAD系统基于不同指南(ACR指南、ATA指南、AACE指南、KSThR共识、BTA指南、Kwak指南、Seo指南、Russ指南)诊断甲状腺恶性结节的受试者工作特征(ROC)曲线,计算曲线下面积(AUC),分析其诊断效能。结果以2分为截断值,KSThR共识诊断甲状腺恶性结节的敏感性90.60%,阴性预测值84.1%,AUC为0.759,均高于其余7个指南(均P<0.01);以分类4类为截断值,BTA指南诊断甲状腺恶性结节的特异性79.95%,阳性预测值70.9%,均高于其余7个指南(均P<0.01)。结论CAD系统对甲状腺良恶性结节的鉴别诊断有较好价值,KSThR共识的AUC和敏感性最高,BTA指南的特异性最高。Objective To compare the diagnostic efficacy of computer-aided diagnosis(CAD)system based on different guidelines for the diagnosis of benign and malignant thyroid nodules.Methods A multicentric prospective study was conducted in 453 patients with 521 thyroid nodules,which were confirmed by pathology of surgery or ultrasound guided fine needle aspiration.Taken pathology as the gold standard,the receiver operating characteristic(ROC)curve of CAD system was obtained based on different guidelines(ACR guideline,ATA guideline,AACE guideline,KSThR consensus,BTA guideline,Kwak guideline,Seo guideline,Russ guideline).The area under the curves(AUC)was calculated and the diagnostic efficiency was analyzed.Results When the cut-off value was 2 scores,the sensitivity,negative predictive value and AUC of KSThR consensus were 90.60%,84.1%and 0.759,respectively,which were higher than those of the other seven guidelines(all P<0.01).When the cut-off value was grade 4,the specificity and positive predictive value of BTA guidelines in the diagnosis of thyroid malignant nodules were 79.95%and 70.9%,respectively,which were higher than the other seven guidelines(all P<0.01).Conclusion The diagnostic efficay of CAD system in the diagnosis of benign and malignant thyroid nodules is satisfying.The KSThR consensus has the highest AUC and sensitivity,and the BTA guidelines has the highest specificity.

关 键 词：超声检查 计算机辅助诊断 甲状腺结节 良恶性 诊断效能 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]