规范化超声诊断和规范化报告在甲状腺结节分层管理中的价值  

Value of Thyroid Imaging Reporting and Data System for Stratifying Management of Thyroid Nodules

作　　者：管玲[1] 王卫丽[1] 陆云[1] 张丽[1] 杜润家[1] 段颖[1] 马亚兵[1] 王丽云[1] Guan Ling;Wang Weili;Lu Yun;Zhang Li;Du Runjia;Duan Ying;Ma Yabing;Wang Liyun(Supporting Department,Gansu Provincial Cancer Hospital,Lanzhou 730050,Gansu,China)

机构地区：[1]甘肃省肿瘤医院功能科,兰州730050

出　　处：《肿瘤预防与治疗》2020年第11期848-854,共7页Journal of Cancer Control And Treatment

基　　金：甘肃省卫生行业科研计划项目(编号:GSWSKY2016-13)。

摘　　要：目的:探讨甲状腺超声规范化诊断及规范化报告在甲状腺结节分层管理中的价值。方法:应用2011年韩国学者Kwak提出的甲状腺超声影像数据报告系统(Thyroid Imaging Reporting and Data System,TI-RADS),回顾性分析2015年1月1日至2018年12月31日就诊于我院的11053例甲状腺疾病患者的彩色多普勒超声规范化诊断及报告,探讨甲状腺超声规范化诊断及报告系统在甲状腺结节分层管理中的价值。结果:对11053例患者共13333个结节进行规范化诊断及报告:TI-RADS I类占8.63%;TI-RADS Ⅱ类占18.50%;TI-RADS Ⅲ类占47.25%;TI-RADS IVa类11.75%;TI-RADS IVb类9.83%;TI-RADS IVc类2.32%;TI-RADS V类1.72%。其中,对632例TI-RADS≥IV类且有手术指征的患者行外科手术治疗取得病理结果。结果显示,随着TI-RADS分级增加,恶性率呈上升趋势。绘制ROC曲线后,曲线下面积为0.918,证明对于TI-RADS≥Ⅳ类甲状腺结节,该分层管理诊断方法具有一定价值。结论:甲状腺超声规范化诊断及报告,为临床诊断和治疗提供客观的影像学依据,有效将甲状腺疾病患者进行分层管理,可达到合理分流、有的放矢、精准诊疗的效果。Objective:To evaluate the value of thyroid imaging reporting and data system(TI-RADS)for stratifying management of thyroid nodules.Methods:Data of 11,053 cases of thyroid diseases by using TI-RADS(proposed by Korean scholar Kwak in 2011)from January 1,2015 to December 31,2018 were retrospectively reviewed.Results:Data of 13,333 cases from 11,053 patients were recorded.According to TI-RADS classification,the percentage of TIRADSⅠ,Ⅱ,Ⅲ,Ⅳa,Ⅳb,Ⅳc,andⅤthyroid nodules were 8.63%,18.50%,47.25%,11.75%,9.83%,2.32%and 1.72%,respectively.Pathological findings of 632 TI-RADS IV or V cases with surgical indications underwent surgical treatment were obtained.The malignancy rate showed an upward trend with the increase of TI-RADS rating.The area under the curve was 0.918,indicating that stratifying management in diagnosis was of certain value for TI-RADSⅣor V thyroid nodules.Conclusion:TIRADS can provide objective imaging evidence for clinical diagnosis and treatment,and can effectively stratify the patients with thyroid diseases,so as to achieve reasonable,target-oriented and accurate diagnosis.

关 键 词：甲状腺超声 诊断和报告 规范化 分层管理 

分 类 号：R736.1[医药卫生—肿瘤] R445.1[医药卫生—临床医学]