梁振威,陈路增,王彬,张惠,邵玉红,孙秀明,陈铭.2017版甲状腺影像报告和数据系统诊断甲状腺良恶性结节的价值[J].中国介入影像与治疗学,2019,16(3):162-166
2017版甲状腺影像报告和数据系统诊断甲状腺良恶性结节的价值
Value of 2017 thyroid imaging reporting and data system in diagnosis of benign and malignant thyroid nodules
投稿时间:2018-08-30  修订日期:2018-12-11
DOI:10.13929/j.1672-8475.201808045
中文关键词:  甲状腺结节  超声检查  甲状腺影像报告和数据系统
英文关键词:thyroid nodule  ultrasonography  thyroid imaging reporting and data system
基金项目:北京大学第一医院青年临床研究专项(2017CR05)。
作者单位E-mail
梁振威 北京大学第一医院超声诊断中心, 北京 100034  
陈路增 北京大学第一医院超声诊断中心, 北京 100034 chenluzeng@126.com 
王彬 北京大学第一医院超声诊断中心, 北京 100034  
张惠 北京大学第一医院超声诊断中心, 北京 100034  
邵玉红 北京大学第一医院超声诊断中心, 北京 100034  
孙秀明 北京大学第一医院超声诊断中心, 北京 100034  
陈铭 北京大学第一医院超声诊断中心, 北京 100034  
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中文摘要:
      目的 探讨2017版美国放射学院甲状腺影像报告和数据系统(TI-RADS)在评估甲状腺良恶性结节中的价值。方法 采用2017版TI-RADS分类诊断标准,回顾性分析1 039例患者共1 109个甲状腺结节的声像图特征;以粗针穿刺活检或手术病理学结果为金标准,评价2017版TI-RADS对不同类别结节的诊断效能。结果 良性结节551个,恶性结节558个;良恶性结节的成分、回声类型、纵横比、边界、有无钙化差异均有统计学意义(P均<0.05)。TI-RADS 2~5类结节中,恶性率分别为0、5.45%(3/55)、22.29%(39/175)和58.84%(516/877),差异有统计学意义(P<0.001)。以TI-RADS分类≥ 4为标准,诊断甲状腺恶性结节的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为99.46%(555/558)、9.80%(54/551)、54.91%(609/1 109)、52.76%(555/1 052)和94.74%(54/57)。结论 根据2017版TI-RADS分类评估恶性甲状腺结节具有临床应用价值,但特异度较低,分类标准尚需进一步完善。
英文摘要:
      Objective To explore the value of 2017 thyroid imaging reporting and data system (TI-RADS) suggested by American College of Radiology in diagnosis of benign and malignant thyroid nodules. Methods According to 2017 TI-RADS, the sonographic features of 1 109 pathologically diagnosed thyroid nodules in 1 039 patients were retrospectively analyzed. Taken coarse needle biopsy or surgical pathology as the gold standards, the diagnostic efficacy of 2017 TI-RADS for different types of nodules was analyzed. Results Of 1 109 nodules, 551 were benign and 558 were malignant. The composition, echogenicity, aspect ratio, boundary and calcification were statistically different between benign and malignant nodules (all P<0.05). The probability of malignancy in nodules with a classification of TI-RADS 2, 3, 4 and 5 was 0, 5.45% (3/55), 22.29% (39/175) and 58.84% (516/877), respectively, which had statistical difference (P<0.001). When TI-RADS classification were larger than 4, the diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value was 99.46% (555/558), 9.80% (54/551), 54.91% (609/1 109), 52.76% (555/1 052) and 94.74% (54/57), respectively. Conclusion 2017 TI-RADS classification is based on the morphology and maximum diameter management of thyroid nodules, demonstrating clinical application value in evaluating malignant nodules, but the specificity is low, therefore needing further improvement.
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