住院医师应用C-TIRADS与其他多种TIRADS诊断甲状腺结节的比较分析  

Comparison of C-TIRADS and Other TIRADS in Thyroid Nodule Diagnosis by Residents

作　　者：黄雪培 冉旭[1] 程双娟 邵玉红[1] 孙秀明[1] 陈路增[1] Huang Xuepei;Ran Xu;Cheng Shuangjuan;Shao Yuhong;Sun Xiuming;Chen Luzeng(Department of Diagnostic Ultrasound,Peking University First Hospital,Beijing 10o034,China)

机构地区：[1]北京大学第一医院超声医学科,北京市100034

出　　处：《中国超声医学杂志》2022年第9期972-975,共4页Chinese Journal of Ultrasound in Medicine

基　　金：北京大学第一医院青年临床研究专项(No.2017CR05)。

摘　　要：目的 比较住院医师应用C-TIRADS与ACR-TIRADS、EU-TIRADS、K-TIRADS、Kwak-TIRADS对甲状腺结节的诊断效能,评估C-TIRADS对甲状腺结节的诊断价值。方法 应用各版TIRADS回顾性分析472例甲状腺结节,以细胞病理学结果为金标准绘制ROC曲线并计算曲线下面积(AUC),确定最佳截断值,通过Kappa检验比较C-TIRADS与其他多种TIRADS的诊断一致性。结果 C-TIRADS的AUC高于ACR-TIRADS、EU-TIRADS、K-TIRADS、Kwak-TIRADS(0.812 vs. 0.751、0.733、0.733、 0.737,P<0.000 1),具有良好的诊断效能,C-TIRADS>4b、ACR-TIRADS>4、EU-TIRADS>4、K-TIRADS>4、Kwak-TIRADS>4b时,C-TIRADS与ACR-TIRADS(Kappa=0.779)、Kwak-TIRADS(Kappa=0.611)诊断一致性较强,与K-TIRADS(Kappa=0.552)、EU-TIRADS(Kappa=0.545)诊断一致性中等,P<0.000 1。结论 住院医师应用C-TIRADS评估甲状腺结节恶性风险的诊断价值良好,C-TIRADS适用于我国甲状腺结节患者的超声分类评估。Objective To compare the diagnostic performance of 2020 Chinese guidelines for malignant risk stratification of thyroid nodules(C-TIRADS) with the thyroid imaging reporting and systems(TIRADS) proposed by American college of radiology(ACR), european thyroid association(EU), korean thyroid association/korean society of thyroid radiology(K) and Kwak(Kwak) in thyroid nodules, and to evaluate the diagnostic value of C-TIRADS for sonographic malignancy risk stratification of thyroid nodules by residents. Methods A total of 472 cases of thyroid nodules were evaluated by C-TIRADS, ACR-TIRADS, EU-TIRADS, K-TIRADS, and Kwak-TIRADS, respectively. With pathology as gold standard, the diagnostic performance was evaluated by ROC curve and the area under the ROC curve(AUC). At the best cut-off value, the consistency was evaluated through the Kappa statistics. Results The AUC of C-TIRADS was higher than ACR-TIRADS, EU-TIRADS, K-TIRADS, and Kwak-TIRADS(0.812 vs. 0.751, 0.733, 0.733, 0.737, P<0.000 1), and all of them had good diagnostic efficiency. The best cut-off points for each TIRADS were C-TIRADS>4 b, ACR-TIRADS>4, EU-TIRADS>4, K-TIRADS>4, Kwak-TIRADS>4 b. The diagnostic results of C-TIRADS and ACR-TIRADS(Kappa=0.779), C-TIRADS and Kwak-TIRADS(Kappa=0.611) had better consistency, while the diagnostic results of C-TIRADS and K-TIRADS(Kappa=0.552), EU-TIRADS(Kappa=0.545) had medium consistency, P<0.000 1. Conclusions The C-TIRADS has high diagnostic value for thyroid nodules which is suitable for sonographic malignancy risk stratification of thyroid nodules.

关 键 词：医学超声 甲状腺结节 甲状腺影像报告与数据系统 

分 类 号：R445.1[医药卫生—影像医学与核医学] R581[医药卫生—诊断学]