北京市海淀区医疗机构甲状腺超声检查及TIRADS分类基线调查  

Survey of basic situation of thyroid ultrasonography and use of TIRADS classification in hospitals in Haidian District,Beijing

作　　者：刘畅[1,2] 蒋洁 胥雪冬[3] 崔立刚 王淑敏[1,2] 陈文[1,2] Chang Liu;Jie Jiang;Xuedong Xu;Ligang Cui;Shumin Wang;Wen Chen(Department of Ultrasound,Ultrasound Medical Quality Control and Improvement Center of Haidian District,Beijing 100191,China;Medical Department,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院超声医学科,北京100191 [2]北京市海淀区超声医学质量控制和改进中心 [3]北京大学第三医院医务处,北京100191

出　　处：《中华医学超声杂志（电子版）》2024年第7期693-697,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的通过对北京市海淀区医疗机构甲状腺超声检查及甲状腺影像报告和数据系统(TIRADS)分类使用情况进行基线调查,探讨推广甲状腺结节超声恶性危险分层的中国指南(C-TIRADS)分类使用对甲状腺超声诊断质量提升的可行性。方法2023年7月13日至7月20日采用线上问卷方式,以北京市海淀区各医疗机构超声科为调查对象,对甲状腺超声检查一般情况、超声报告TIRADS分类使用情况及甲状腺超声检查报告阳性率和诊断符合率进行调查研究。结果本次调查共计回收问卷105份,去除无效问卷后,最终纳入有效问卷共91份。91家医疗机构中,共有70家(76.9%)医疗机构常规开展甲状腺超声检查,包括三级和二级医院各12家以及一级医院46家。在进行甲状腺超声检查的医疗机构中,12.9%(9/70)的医疗机构常规开展超声引导下甲状腺相关介入操作(包括穿刺活检)技术,且主要集中在三级医院完成,二级医院中仅有1家医院开展,一级医院均未开展。共有35家(50.0%)医疗机构在超声报告中使用了TIRADS分类系统,其中22家(62.9%)使用C-TIRADS、11家(31.4%)使用美国放射学会TIRADS、2家(5.7%)使用美国甲状腺协会指南,其他分类系统未有使用。甲状腺结节超声平均报告阳性率为73.1%,平均诊断符合率为85.3%。结论北京市海淀区目前C-TIRADS使用覆盖率仍有提升空间,海淀区超声医学质量控制和改进中心将持续加强甲状腺超声检查的质量控制工作,推广C-TIRADS在甲状腺结节诊断中的应用,提高诊断符合率。Objective To investigate the basic situation of thyroid ultrasound examination and the use of TIRADS classification in hospitals in Haidian District,and explore the feasibility of promoting the use of the Chinese version of TIRADS(C-TIRADS)to improve the ultrasound diagnosis quality.Methods An online questionnaire was administered and collected through a WeChat application,and the subjects of the survey were ultrasound departments of hospitals in Haidian District.The questionnaire mainly included three parts:general information of thyroid ultrasound examination,the use of the TIRADS classification,and the report positive rate and diagnostic accordance rate.Results A total of 105 questionnaires were collected,of which 91 were valid after removing invalid ones.Seventy(76.9%)hospitals routinely performed thyroid ultrasound examinations,including 12 tertiary and 12 secondary hospitals,as well as 46 primary hospitals.Approximately 12.9%(9/70)of them,mainly tertiary hospitals,performed ultrasound-guided thyroid intervention techniques(including biopsy).Only one secondary hospital conducted these procedures,and none of primary hospitals performed.A total of 35 hospitals(50.0%)used TIRADS classification systems in their ultrasound reports,of which 22(62.9%)used the C-TIRADS,11(31.4%)used the ACR-TIRADS,and 2(5.7%)used the ATA guidelines.The average report positive rate of thyroid ultrasound was 73.1%and the average diagnostic accordance rate was 85.3%.Conclusion Further improvement in the coverage of C-TIRADS usage in hospitals in Haidian District is needed.The Ultrasound Medical Quality Control and Improvement Center of Haidian District will continue to strengthen the quality control of thyroid ultrasonography,promote the use of C-TIRADS in the diagnosis of thyroid nodules,and improve the diagnostic accordance rate.

关 键 词：甲状腺结节 超声 质量控制 甲状腺影像报告和数据系统 基线调查 

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]