多模态超声量化评分鉴别甲状腺结节良恶性的诊断效能  

Research of differentiation of benign and malignant thyroid nodules by multimodal ultrasound quantitative scoring

作　　者：付莹 姜双全[1] 田家玮[1] FU Ying;JIANG Shuang-quan;TIAN Jia-wei(Department of Ultrasound,The Second Affiliated Hospital of Harbin Medical University,Harbin 150081,China;Department of Ultrasound,The Fourth Hospital of Harbin,Harbin 150026,China)

机构地区：[1]哈尔滨医科大学附属第二医院超声医学科,黑龙江哈尔滨150081 [2]哈尔滨市第四医院超声科,黑龙江哈尔滨150026

出　　处：《哈尔滨医科大学学报》2022年第2期133-137,共5页Journal of Harbin Medical University

摘　　要：目的 探讨一种基于多模态超声的量化评分方法(简称新评分法)用于甲状腺结节良恶性鉴别的诊断效能。方法 回顾性分析2018年1月~2020年10月于哈尔滨医科大学附属第二医院甲状腺外科住院行手术治疗且由手术病理证实的1 023例甲状腺结节患者的超声资料和病理结果,分别应用由美国放射学会(American College of Radiology, ACR)推出的甲状腺影像学报告及数据系统(thyroid imaging reporting and data system, TI-RADS)分类法及新评分法对结节进行评分,对比两种方法的诊断效能。结果 (1)纳入研究的1 023枚结节中803枚为恶性(78.49%),220枚为良性(21.51%);(2)ROC曲线分析:ACR TI-RADS分类法的曲线下面积(area under curve, AUC)为0.806,最佳截断值6.5,敏感性87.42%,特异性64.09%,准确性82.40%,阳性预测值89.58%,阴性预测值58.47%;新评分法曲线下面积(AUC)为0.867,最佳截断值为6.5,敏感性96.01%,特异性61.82%,准确性88.66%,阳性预测值90.18%,阴性预测值80.95%;两种方法比较,AUC、敏感性、准确性及阴性预测值差异具有统计学意义(P<0.001)。结论 新评分法可以有效鉴别甲状腺结节的良恶性,且较ACR TI-RADS分类法具有更高的敏感性及阴性预测值。Objective To establish a quantitative score method based on multimodal ultrasonography for the differentiation of benign and malignant thyroid nodules and to explore its diagnostic efficacy. Methods The ultrasound data and pathological results of 1 023 cases of thyroid nodules admitted to the Department of Thyroid Surgery of the Second Affiliated Hospital of Harbin Medical University from January 2018 to October 2020 were retrospectively analyzed. The nodules were scored by thyroid imaging reporting and data system(TI-RADS) released by American College of Radiology(ACR), and the nodules were also scored by the multimodal ultrasonic quantitative score method. The diagnostic efficacy of the two methods was compared. Results(1)Among the 1 023 nodules, 803 nodules were malignant(78.49%) and 220 nodules were benign(21.51%).(2)ROC curve analysis results showed that the area under curve(AUC) of ACR TI-RADS was 0.806, the best cutoff value was 6.5, the sensitivity was 87.42%, the specificity was 64.09%, the accuracy was 82.40%,the positive predictive value was 89.58%, the negative predictive value was 58.47%. While the AUC of the multimodal ultrasound quantitative score was 0.867, the best cutoff value was 6.5, the sensitivity was 96.01%, the specificity was 61.82%, the accuracy was 88.66%, the positive predictive value was 90.18%, and the negative predictive value was 80.95%. The difference in AUC,sensitivity, accuracy and the negative predictive value between the two methods was statistically significant(P<0.001). Conclusion The multimodal ultrasound quantitative score method established in this study can effectively distinguish the benign and malignant thyroid nodules, and has higher sensitivity and the negative predictive value than ACR TI-RADS.

关 键 词：多模态超声 甲状腺结节 量化评分方法 鉴别诊断 

分 类 号：R581.3[医药卫生—内分泌]