以7种不同甲状腺影像报告和数据系统鉴别桥本甲状腺炎背景下甲状腺良、恶性结节  

Seven thyroid imaging reporting and data systems for differentiating benign and malignant thyroid nodules under the context of Hashimoto thyroiditis

作　　者：孙鑫 张巍[1] 程令刚[1] 广旸 张雨康 SUN Xin;ZHANG Wei;CHENG Linggang;GUANG Yang;ZHANG Yukang(Department of Ultrasound,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院超声科,北京100070

出　　处：《中国医学影像技术》2024年第2期212-216,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的比较7种不同甲状腺影像报告和数据系统(TI-RADS)用于鉴别桥本甲状腺炎(HT)背景下甲状腺良、恶性结节的价值。方法纳入200例HT患者共338个甲状腺结节,良性167个、恶性171个。分别采用Kwak-TIRADS、美国甲状腺学会(ATA)指南、美国临床内分泌医师协会(AACE)/美国内分泌协会(ACE)/意大利内分泌协会(AME)指南、韩国甲状腺放射学会K-TIRADS、欧洲甲状腺协会EU-TIRADS、美国放射协会(ACR)-TIRADS、中华医学会超声医学分会浅表器官和血管组《2020甲状腺结节超声恶性危险分层的中国指南》(C-TIRADS)对甲状腺结节进行分类;以病理结果为金标准,评估各TI-RADS的诊断效能。结果Kwak-TIRADS、ATA指南、AACE/ACE/AME指南、K-TIRADS、EU-TIRADS、ACR-TIRADS及C-TIRADS鉴别HT背景下甲状腺良、恶性结节的敏感度分别为97.08%、98.25%、99.42%、95.91%、99.42%、90.06%及99.42%,特异度依次为88.02%、83.23%、82.04%、88.02%、82.04%、86.83%及84.43%,曲线下面积(AUC)分别为0.946、0.913、0.907、0.934、0.909、0.916及0.960。C-TIRADS、EU-TIRADS及AACE/ACE/AME指南的敏感度均高于K-TIRADS和ACR-TIRADS(P均<0.05),Kawk-TIRADS和K-TIRADS的特异度均高于C-TIRADS、ATA指南、EU-TIRADS及AACE/ACE/AME指南(P均<0.05),C-TIRADS和Kawk-TIRADS的AUC均高于其他TI-RADS(P均<0.05)。以Kwak-TIRADS、ATA指南、AACE/ACE/AME指南、K-TIRADS、EU-TIRADS、ACR-TIRADS、C-TIRADS鉴别HT背景下甲状腺良、恶性结节,同一TI-RADS中各等级结节恶性率差异均有统计学意义(P均<0.05),且结节恶性率均随TI-RADS分类等级增高而上升。结论C-TIRADS和Kawk-TIRADS鉴别HT背景下甲状腺良、恶性结节具有较高价值;其中,C-TIRADS敏感度较高,Kawk-TIRADS特异度较高。Objective To compare the value of 7 different thyroid imaging reporting and data systems(TI-RADS)for differentiating benign and malignant thyroid nodules under the context of Hashimoto thyroiditis(HT).Methods A total of 338 thyroid nodules in 200 HT patients were enrolled,including 167 benign and 171 malignant ones.Kwak-TIRADS,American Thyroid Association(ATA)guideline,American Association of Clinical Endocrinologists(AACE)/American College of Endocrinology(ACE)/Associazione Medici Endocrinologi(AME)guideline,K-TIRADS of Korean Society of Thyroid Radiology,EU-TIRADS of European Thyroid Association,American College of Radiology(ACR)-TIRADS and 2020 Chinese guidelines for malignant risk stratification of thyroid nodules by ultrasound proposed by the superficial organs and vessels group of the ultrasound medicine branch of the Chinese Medical Association(C-TIRADS)were used for grading of benign and malignant thyroid nodules.Taken pathological results as gold standards,the diagnostic efficacy of 7 kinds of TI-RADS were analyzed.Results The sensitivity of Kwak-TIRADS,ATA guideline,AACE/ACE/AME guideline,K-TIRADS,EU-TIRADS,ACR-TIRADS and C-TIRADS for differentiating benign and malignant thyroid nodules under the context of HT was 97.08%,98.25%,99.42%,95.91%,99.42%,90.06%and 99.42%,respectively,the specificity was 88.02%,83.23%,82.04%,88.02%,82.04%,86.83%and 84.43%,respectively,and the area under the curve(AUC)was 0.946,0.913,0.907,0.934,0.909,0.916 and 0.960,respectively.The sensitivity of C-TIRADS,EU-TIRADS and AACE/ACE/AME guideline were all higher than that of K-TIRADS and ACR-TIRADS(all P<0.05),and the specificity of Kawk-TIRADS and K-TIRADS were both higher than that of C-TIRADS,ATA guideline,EU-TIRADS and AACE/ACE/AME guideline(all P<0.05),while AUC of C-TIRADS and Kawk-TIRADS were both higher than that of the rest 5 kinds of TI-RADS(all P<0.05).According to Kwak-TIRADS,ATA guideline,AACE/ACE/AME guideline,K-TIRADS,EU-TIRADS,ACR-TIRADS and C-TIRADS,the malignant rate of different grades nodules identified with th

关 键 词：桥本病 甲状腺结节 甲状腺影像报告和数据系统 超声检查 

分 类 号：R581.4[医药卫生—内分泌] R445.1[医药卫生—内科学]