基于ACR TI⁃RADS分析S⁃Thyroid和超声医师评估甲状腺结节的一致性  

Consistency between S⁃Thyroid and sonographer in evaluating thyroid nodules with ACR TI⁃RADS

作　　者：周跃 李卫民 范晓芳 高启[2] 吴文娟 贾磊 ZHOU Yue;LI Weimin;FAN Xiaofang;GAO Qi;WU Wenjuan;JIA Lei(Department of Ultrasound,Affiliated Hospital of Jiangnan University,Wuxi 214000,China;不详)

机构地区：[1]江南大学附属医院超声医学科,江苏无锡214000 [2]东南大学附属中大医院超声医学科,南京210009

出　　处：《实用医学杂志》2022年第18期2352-2356,共5页The Journal of Practical Medicine

基　　金：无锡市妇幼健康推广项目(编号:FYTG202103)。

摘　　要：目的根据美国放射学会制定的甲状腺影像报告与数据系统(ACR TI⁃RADS),分析甲状腺自动扫查助手(S⁃Thyroid)和超声医师对甲状腺结节超声特征评估的一致性和两者的诊断效能。方法选取甲状腺结节患者253例共276个结节,分别由甲状腺扫查助手(S⁃Thyroid)和超声医师对甲状腺结节的超声特征进行评估,采用Cohen′s Kappa检验分析S⁃Thyroid和超声医师对甲状腺结节超声特征评估的一致性,并以手术病理为金标准,绘制ROC曲线,分析二者的诊断效能。结果276个结节中,良性89个,恶性187个。S⁃Thyroid和超声医师对甲状腺结节形态、内部结构以及回声的评估一致性强(Kappa值分别为0.973、0.886、0.805),对强回声灶和边缘评估的一致性中等(Kappa值分别为0.613、0.597)。在诊断效能方面,S⁃Thyroid和超声医师对甲状腺恶性结节的敏感度、特异度分别为82.01%vs.86.24%,86.21%vs.83.91%,差异均无统计学意义(均P>0.05);曲线下面积(AUC)分别为0.835(95%CI:0.801~0.926)、0.891(95%CI:0.846~0.936),差异无统计学意义(Z=0.913,P>0.05)。结论根据ACR评分标准,S⁃Thyroid和超声医师对甲状腺结节超声特征的评估有着较好的一致性,且具有较高的诊断效能,值得进一步推广和应用。Objective To investigate the consistency of S⁃Thyroid and sonographer in the evaluating char⁃acteristics of thyroid nodules according to American College of Radiology Thyroid Imaging Report and Data System(ACR TI⁃RADS)and compare their diagnostic efficiency.Methods A total of 253 patients with 276 thyroid nod⁃ules were enrolled in the study.The ultrasonic characteristics of thyroid nodules were evaluated by S⁃Thyroid and sonographers respectively.Cohen's kappa test was used to evaluate the consistency between S⁃Thyroid and sonogra⁃phers in the diagnosis.Taking surgical pathology as gold standard,ROC curves were drawn and diagnostic efficacy was analyzed.Results In terms of ultrasonic characteristics,there were high consistency in morphology and inter⁃nal structure(Kappa values were 0.973,0.886,0.805,respectively)and medium consistency in hyperechoic foci and edges(Kappa values were 0.613 and 0.597,respectively).Meanwhile,the sensitivity and specificity of S⁃Thy⁃roid and sonographers were 82.01%vs.86.24%and 86.21%vs.83.91%,respectively.There were no significant dif⁃ference(P>0.05).The area under the curve was 0.835(95%CI:0.801~0.926)and 0.891(95%CI:0.846~0.936),respectively,and there was no significant difference between them(Z=0.913,P>0.05).Conclusion According to the criteria of ACR TI⁃RADS,there are good consistency and high diagnostic efficiency in the evalua⁃tion of thyroid nodules between S⁃Thyroid and sonographers in evaluating thyroid nodules.Therefore,S⁃Thyroid is worthy of further popularization and application in clinic.

关 键 词：甲状腺影像报告与数据系统 甲状腺自动扫查助手 超声 甲状腺结节 一致性 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]