2020中国超声甲状腺影像报告和数据系统鉴别甲状腺结节良恶性的价值  

Value of 2020 Chinese TI-RADS in the diagnosis of benign and malignant thyroid nodules

作　　者：李荣斌[1] 李拾林[2] LI Rongbin;LI Shilin(不详;Department of Ultrasound,Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China)

机构地区：[1]福建省厦门市第三医院超声医学科,福建厦门361100 [2]福建医科大学附属第二医院超声医学科,福建泉州362000

出　　处：《中国中西医结合影像学杂志》2022年第2期154-157,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:外部验证2020中国超声甲状腺影像报告和数据系统(C-TIRADS)、2017年美国放射学院发布的甲状腺超声影像报告和数据系统(ACR TI-RADS)及Kwak提出的甲状腺影像报告和数据系统(Kwak TI-RADS)在甲状腺结节良恶性鉴别中的效能。方法:回顾性分析经手术病理证实的481例(513个)甲状腺结节(良性307个,恶性206个)的超声图像。统计3种分类的恶性百分比,以手术病理结果为金标准,绘制3种分类的ROC曲线,确定最佳截断值,分析、比较3种分类对甲状腺结节良恶性的鉴别诊断效能。结果:C-TIRADS、ACR TI-RADS及Kwak TI-RADS 3种分类的最佳截断值分别为CTIRADS 4b类、ACR TI-RADS 4类、Kwak TI-RADS 4b类,AUC分别为0.890、0.894、0.897,两两比较差异均无统计学意义(均P>0.05);敏感度分别为0.808、0.944、0.901,两两比较,C-TIRADS敏感度略低于ACR TI-RADS及Kwak TI-RADS,差异均有统计学意义(均P<0.05);特异度分别为0.701、0.591、0.634,两两比较,C-TIRADS比ACR TI-RADS及Kwak TI-RADS分类的特异度更高,差异均有统计学意义(均P<0.05)。结论:3种分类对甲状腺结节良恶性的鉴别均具有较高的诊断效能;ACR TI-RADS分类具有较高的敏感度,但操作较繁琐;C-TIRADS分类较简便,且具有更高的特异度,可在各级医院推广。Objective:To investigate the efficacy of 2020 Chinese Ultrasound Thyroid Imaging Reporting and Data System(C-TIRADS),the TI-RADS issued by the American College of Radiology(ACR)in 2017,and the TI-RADS proposed by Kwak(efficacy of Kwak TI-RADS)in the differentiation of benign and malignant thyroid nodules.Methods:Ultrasound images of 481 patients with 513 thyroid nodules(307 benign and 206 malignant)confirmed by surgery and pathology were retrospectively analyzed.The malignant percentages were counted according to the C-TIRADS classification,Kwak TI-RADS and ACR TI-RADS.All of them were based on the surgical pathological results as the golden standard.The ROC curve of the subjects were drawn to determine the best diagnostic cut-off values of the three guidelines.The diagnostic efficacy of three classifications in benign and malignant thyroid nodules were analyzed and compared.Results:In all 513 thyroid nodules,cut-off value of 3 methods was C-TIRADS category 4b,ACR TI-RADS category 4,Kwak TI-RADS category 4b,and the AUC of C-TIRADS,ACR TI-RADS,Kwak TI-RADS classifications were 0.890,0.894,0.897,and there was no significant difference(P>0.05).The sensitivity of C-TIRADS,ACR TI-RADS,Kwak TI-RADS classifications were 0.808,0.944,0.901,the sensitivity of C-TIRAD was lower than that of ACR TI-RADS and Kwak TI-RADS,and there were significant differences(P<0.05).The specificity of C-TIRADS,ACR TI-RADS,Kwak TI-RADS classifications were 0.701,0.591,0.634,the specificity of C-TIRADS was higher than that of ACR TI-RADS and Kwak TI-RADS,and there were significant differences(P<0.05).Conclusions:The C-TIRADS,Kwak TI-RADS and ACR TI-RADS guidelines have high diagnostic efficacy in the differential diagnosis of benign and malignant thyroid nodules,and the ACR TI-RADS is more complicated,but it has higher sensitivity.C-TIRADS is simpler and has higher specificity,and can be popularized in hospitals at all levels.

关 键 词：超声检查 甲状腺影像学报告及数据系统 甲状腺结节 诊断 

分 类 号：R581[医药卫生—内分泌]