ACR TI-RADS和Kwak TI-RADS对儿童甲状腺结节的诊断效能  

Diagnostic Performance of ACR TI-RADS and Kwak TI-RADS in Pediatric Thyroid Nodules

作　　者：崔艺杨 付超[1] 司彩凤[1] 崔可飞[1] CUI Yiyang;FU Chao;SI Caifeng;CUI Kefei(Department of Ultrasound,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院超声科,河南郑州450000

出　　处：《河南医学研究》2022年第23期4262-4266,共5页Henan Medical Research

摘　　要：目的探讨2017年美国放射学会发布的甲状腺影像报告和数据系统(ACR TI-RADS)和2011年Kwak TI-RADS对儿童甲状腺结节的诊断效能。方法回顾性分析2018年10月至2022年5月郑州大学第一附属医院收治的145例儿童甲状腺结节患者(共170例结节)的资料,分析在不同穿刺活检阈值标准下二者对儿童甲状腺结节的诊断价值。结果(1)170例结节包括恶性结节97例(57.06%)和良性结节73例(42.94%)。(2)ACR TI-RADS和Kwak TI-RADS的受试者工作特征曲线下面积分别为0.887和0.879(P=0.465)。(3)当对高度可疑恶性结节全部建议穿刺时,ACR TI-RADS的漏诊率从32.14%降至8.77%(χ^(2)=10.572,P=0.001),Kwak TI-RADS的漏诊率从32.43%降至4.26%(χ^(2)=13.527,P<0.001),并且二者的非必要穿刺率差异无统计学意义(P=0.997,0.836)。结论ACR TI-RADS和Kwak TI-RADS鉴别儿童甲状腺结节良恶性的诊断效能相当,但二者对恶性结节的漏诊率均较高,通过对高度可疑恶性结节全部建议穿刺,可以显著降低漏诊率,进一步提高诊断效能。Objective To investigate the diagnostic performance of the thyroid imaging reporting and data system proposed by American College of Radiology(ACR TI-RADS)and Kwak TI-RADS in pediatric thyroid nodules.Methods The data of 145 children with thyroid nodules(170 in total)admitted to the First Affiliated Hospital of Zhengzhou University from October 2018 to May 2022 were retrospectively analyzed.The diagnostic value of the two methods in children with thyroid nodules under different biopsy thresholds was analyzed.Results(1)Of the 170 thyroid nodules,97(57.06%)were malignant and 73(42.94%)were benign.(2)The receiver operating characteristic area under the curve of ACR TI-RADS and Kwak TI-RADS were 0.887,0.879,respectively(P=0.465).(3)When all of the nodules with high suspicious of malignancy were recommended for biopsy,the missed malignancy rate was decreased from 32.14%to 8.77%(χ^(2)=10.572,P=0.001)in ACR TI-RADS and dropped from 32.43%to 4.26%(χ^(2)=13.527,P<0.001)in Kwak TI-RADS,while there was no significant difference in the unnecessary biopsy rates between the two groups(P=0.997,0.836,respectively).Conclusion ACR TI-RADS and Kwak TI-RADS have comparable diagnostic efficacy for pediatric thyroid nodules,but both have a high missed malignancy rate.By recommending biopsy of all high suspicious malignant nodules,the missed malignancy rate can be reduced substantially with further improved diagnostic performance.

关 键 词：儿童 甲状腺结节 超声 甲状腺影像报告和数据系统 

分 类 号：R445.1[医药卫生—影像医学与核医学]