ACR-TIRADS和C-TIRADS对老年甲状腺结节诊断价值的对比研究  

Comparative study on the diagnosing value of ACR-TIRADS and C-TIRADS for thyroid nodules in elderly

作　　者：刘牛 吴意赟 周正国 董维露 LIU Niu;WU Yiyun;ZHOU Zhengguo;DONG Weilu(Department of Ultrasound,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院(江苏省中医院)超声医学科,江苏省南京市210029

出　　处：《实用老年医学》2025年第3期245-248,共4页Practical Geriatrics

基　　金：江苏省科技厅资助项目(BE2022789);江苏省重点社会发展项目(BE2018703);江苏省第六期“333高层次人才培养工程”(2022-3-25-069);江苏省中医院创新发展项目(Y2021ZR06)。

摘　　要：目的比较美国版甲状腺影像数据与报告系统(ACR-TIRADS)和中国版甲状腺影像数据与报告系统(C-TIRADS)对老年甲状腺结节的诊断效率。方法回顾性分析南京中医药大学附属医院有完整甲状腺超声图像和手术病理的老年病人,共71例97个结节,根据ACR-TIRADS和C-TIRADS进行超声分类和是否进行细针穿刺抽吸(FNA)的处理建议,比较两种系统的诊断效能、FNA的推荐穿刺率。结果以病理结果为金标准,ACR-TIRADS对老年甲状腺结节诊断的敏感度、特异度、阳性预测值、阴性预测值和准确度分别为89.30%、77.30%、93.10%、68.00%和86.59%,C-TIRADS对老年甲状腺结节诊断的敏感度、特异度、阳性预测值、阴性预测值和准确度分别为89.30%、68.20%、90.50%、65.20%和84.54%,两种方法之间的差异均无统计学意义(P>0.05)。C-TIRADS推荐的总体穿刺率、良性结节和恶性结节穿刺率均显著高于ACR-TIRADS(63.92%、68.18%、62.66%比21.65%、22.73%、21.33%,P均<0.05)。结论ACR-TIRADS和C-TIRADS对老年甲状腺结节均有较高的诊断价值,而C-TIRADS有更高的推荐穿刺率。Objective To compare the diagnosing value of American College of Radiology Thyroid Imaging Reporting and Data System(ACR-TIRADS)and Chinese Thyroid Imaging Reporting and Data System(C-TIRADS)for thyroid nodules in the elderly patients.Methods Retrospective analysis was performed.A total of 71 elderly patients(including 97 nodules)with complete thyroid ultrasound images and surgical pathology in Affiliated Hospital of Nanjing University of Chinese Medicine were enrolled in this study.Ultrasound classification and fine needle aspiration(FNA)treatment recommendations were made according to ACR-TIRADS and C-TIRADS,and the diagnostic performance and recommended FNA rate of the two systems were compared.Results The pathological diagnosis as the gold standard,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of ACR-TIRADS in the diagnosis of thyroid nodules in the elderly were 89.30%,77.30%,93.10%,68.00%and 86.59%,respectively,compared with 89.30%,68.20%,90.50%,65.20%and 84.54%of C-TIRADS(P>0.05).The overall recommended FNA rate,and the acupuncture rates of benign and malignant nodules of C-TIRADS were significantly higher than those of ACR-TIRADS(63.92%,68.18%,62.66%vs 21.65%,22.73%,21.33%,all P<0.05).Conclusions Both ACR-TIRADS and C-TIRADS have high diagnostic value for thyroid nodules in the elderly,while C-TIRADS has a higher recommended puncture rate.

关 键 词：甲状腺结节 老年人 超声 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]