基于甲状腺成像报告和数据系统分类的计算机辅助诊断系统对甲状腺癌超声诊断的辅助价值  

Auxiliary value of computer-assisted diagnosis system based on thyroid imaging reporting and data system for ultrasound diagnosis of thyroid cancer

作　　者：金壮 朱亚琼[1] 张诗杰 宋青[1] 罗渝昆[1] Jin Zhuang;Zhu Yaqiong;Zhang Shijie;Song Qing;Luo Yukun(Department of Ultrasound,First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;Department of Ultrasound,General Hospital of Northern Theater Command,Shenyang 110016,China;Institute of Frontier Interdisciplinary Disciplines,Peking University,Beijing 100871,China)

机构地区：[1]解放军总医院第一医学中心超声科,北京100853 [2]北部战区总医院超声科,沈阳110016 [3]北京大学前沿交叉学科研究院,100871

出　　处：《中华医学超声杂志（电子版）》2022年第5期340-346,共7页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：国家自然科学基金(81771834)。

摘　　要：目的探讨基于甲状腺成像报告和数据系统(TI-RADS)分类的计算机辅助诊断(CAD)系统对超声医师诊断甲状腺癌的辅助价值.方法收集2018年10月至2019年3月在国内5家医院的400例甲状腺结节超声图像进行多中心回顾性研究.采用由北京大学前沿交叉学科研究院研发的基于TI-RADS分类的CAD系统,超声医师诊断甲状腺癌的诊断模式分为无CAD模式和CAD模式,11名具有不同工作经验的超声医师(低年资超声医师4名,中年资超声医师4名,高年资超声医师3名)在上述2种模式下诊断甲状腺癌.比较2种诊断模式的诊断效能及读片时间:绘制CAD系统和超声医师诊断甲状腺癌的受试者工作特征(ROC)曲线,应用DeLong方法比较2种模式下曲线下面积(AUC)的差异;应用配对t检验比较2种模式的读片时间差异.结果在CAD模式下,所有超声医师诊断甲状腺癌的AUC值较无CAD模式有显著提高[0.848(0.837~0.858)vs 0.800(0.788~0.812)],差异具有统计学意义(P<0.001);敏感度从73.8%(95%CI:71.9%~75.6%)提升到82.7%(95%CI:81.0%~84.3%),差异具有统计学意义(x^(2)=9.870,P<0.001);特异度从86.2%(84.7%~87.6%)提升到86.9%(85.4%~88.3%),但差异无统计学意义(x^(2)=0.021,P=0.379).进行亚组分析时,在CAD模式下,低年资超声医师和中年资超声医师诊断甲状腺癌的AUC值较无CAD模式有显著提高(0.840 vs 0.740;0.848 vs 0.814),差异具有统计学意义(P<0.001、=0.001),但高年资超声医师诊断甲状腺癌的AUC值较无CAD模式无明显变化(0.859 vs0.861,P=0.861).在CAD模式下,所有超声医师的阅片时间较无CAD模式减少[(20.2±8.2)svs(22.7±9.6)s],差异具有统计学意义(r=-23.9,P<0.001).结论CAD模式有助于低年资超声医师和中年资超声医师对甲状腺癌的诊断,同时缩短了诊断时间.Objective To assess the value of a computer aided diagnosis(CAD)system based on the classification of thyroid imaging reporting and data system(TI-RADS)in the ultrasound diagnosis of thyroid cancer.Methods From October 2018 to March 2019,400 cases of thyroid nodules were collected at five domestic hospitals for a multi-center retrospective study.A CAD system based on the TI-RADS classification developed by Peking University was used.With and without the aid of the CAD system,11 radiologists with different experiences(4 junior radiologists,4 intermediate-level radiologists,and 3 senior radiologists)diagnosed thyroid cancer,respectively.The area under the receiver operating characteristic(ROC)curve(AUC)was compared using the DeLong method,the sensitivity and specificity were compared using the paired chi-square test,and the reading time was compared using the paired t test.Results With the aid of the CAD system,the average AUC of all radiologists for diagnosing thyroid cancer was significantly higher than that without the aid of the CAD system[0.800(0.788-0.812)vs 0.848(0.837-0.858),P<0.001];the sensitivity significantly increased from 73.8%(71.9%-75.6%)to 82.7%(81.0%-84.3%,x^(2)=9.870,P<0.001),and the specificity increased from 86.2%(84.7%-87.6%)to 86.9%(85.4%-88.3%),but there was no statistical difference(x^(2)=0.021,P=0.379).When performing subgroup analysis,with the aid of the CAD system,the AUC values of junior and intermediate-level radiologists for diagnosing thyroid cancer were significantly higher than those without the aid of the CAD system(junior radiologists:0.740 vs 0.840,P<0.001;intermediate-level radiologists:0.814 vs 0.848,P=0.001),but the AUC value of senior radiologists was not significantly different from that without the aid of the CAD system(0.861 vs 0.859,P=0.861).With the aid of the CAD system,the reading time of all radiologists was significantly shortened compared with that without the aid of the CAD system(22.7±9.6 vs 20.2±8.2;P<0.001).Conclusion The CAD system is helpful in the diagnosi

关 键 词：计算机辅助诊断 甲状腺肿瘤 超声 超声医师 

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]