Kwak与ACR TI-RADS分类对儿童甲状腺结节的诊断价值研究  

Comparison of Kwak TI-RADS and ACR TI-RADS in the Classification and Diagnosis of Children Thyroid Nodules

作　　者：梁振威 邵玉红[1] 易圣果 陈蕾[1] 余洋[2] 高莹[2] 陈路增[1] Liang Zhenwei;Shao Yuhong;Yi Shengguo;Chen Lei;Yu Yang;Gao Ying;Chen Luzeng(Department of Ultrasound,Peking University First Hospital,Beijing 100034,China;Endocrinology,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院超声医学科,北京市100034 [2]北京大学第一医院内分泌科,北京市100034

出　　处：《中国超声医学杂志》2021年第5期492-494,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨Kwak TI-RADS与ACR TI-RADS对儿童甲状腺结节的诊断效能及应用价值。方法回顾性分析68个儿童甲状腺结节,构建受试者工作特性曲线(ROC),分析ACR TI-RADS和Kwak TI-RADS对儿童甲状腺结节的应用价值。结果两种分类方法恶性度均随分类级别增加而增高,以Kwak TI-RADS 4b类和ACR TI-RADS 4类为最佳诊断点,Kwak TI-RADS的特异度略高于ACR TI-RADS(54.5%∶51.5%,P<0.05),但两者灵敏度、PPV、NPV、AUC均无统计学意义(P>0.05);按照ACR TI-RADS成人推荐甲状腺结节穿刺标准,28%(7/25)儿童恶性结节没有分入建议穿刺组。结论Kwak TI-RADS和ACR TI-RADS对儿童甲状腺结节分类均具有较好的指导作用,Kwak TI-RADS具有相对较高特异度,但儿童甲状腺结节在应用ACR TI-RADS推荐的穿刺标准尚需进一步研究。Objective To explore the diagnostic efficiency of thyroid imaging reporting and data system made by Kwak(Kwak TI-RADS)and American College of Radiology(ACR TI-RADS)in pediatric thyroid nodules.Methods The study population consists of 68 nodules from 64 patients.We assessed area under the receiver operating characteristic curve(ROC)to compare the discriminative diagnostic ability of the Kwak TI-RADS and ACR TI-RADS.Results As the increase of the nodules′category,and the malignant rate increases.The best diagnostic cut-off point of Kwak TI-RADS was≥4 b and that of ACR TI-RADS was≥4,the specificity of Kwak TI-RADS was higher than ACR TI-RADS(54.5%vs 51.5%,P<0.05).There was no significant difference in the PPV,NPV,sensitivity,accuracy and AUC between Kwak and ACR TI-RADS(P>0.05).According to the ACR TI-RADS nodule size recommended for adult,28%(7/25)malignant nodules of children were not recommended fine needle biopsy.Conclusions Both TI-RADS classifications suggested by Kwak and ACR are significantly valuable in the differential of pediatric thyroid nodules.Kwak TI-RADS has better performance in specificity compared with ACR TI-RADS.Further work to adjust the recommendations of biopsy for pediatric patients is necessary.

关 键 词：儿童甲状腺结节 超声检查 甲状腺影像报告和数据系统 

分 类 号：R445.1[医药卫生—影像医学与核医学] R725.8[医药卫生—诊断学]