陈泳愉,黄伟俊,钟敏莹.2017年美国放射学会甲状腺影像报告与数据系统鉴别甲状腺良恶性结节[J].中国介入影像与治疗学,2019,16(5):294-298
2017年美国放射学会甲状腺影像报告与数据系统鉴别甲状腺良恶性结节
2017 American Radiology of Society thyroid imaging report and data system classification in differentiating benign and malignant thyroid nodules
投稿时间:2018-09-16  修订日期:2019-03-28
DOI:10.13929/j.1672-8475.201809016
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 report and data system
基金项目:
作者单位E-mail
陈泳愉 佛山市第一人民医院超声诊疗中心, 广东 佛山 528000  
黄伟俊 佛山市第一人民医院超声诊疗中心, 广东 佛山 528000 hwjun36@126.com 
钟敏莹 佛山市南海区人民医院超声科, 广东 佛山 528000  
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中文摘要:
      目的 探讨2017年美国放射学会(ACR)推荐的甲状腺影像报告与数据系统(TI-RADS)对鉴别甲状腺良恶性结节的应用价值。方法 回顾性分析经手术病理确诊的497个甲状腺结节的超声资料,采用2017年ACR TI-RADS分类对结节评分和分类,与病理结果对照,采用ROC确定最佳临界评分,计算TI-RADS分类诊断良恶性结节的敏感度、特异度和准确率。评价高年资与低年资医师采用此最佳临界评分诊断甲状腺良恶性结节的效能和一致性。结果 采用2017年ACR TI-RADS分类诊断甲状腺恶性结节的ROC曲线下面积为0.883(P<0.001),最佳临界评分为5分,敏感度86.22%,特异度78.68%。以TI-RADS评分> 5分归为恶性结节,高年资和低年资医师诊断的敏感度、特异度、准确率分别为78.22%(176/225)、76.47%(208/272)、77.26%(384/497)和77.33%(174/225)、74.26%(202/272)、75.65%(376/497),二者诊断良恶性结节具有中等一致性(Kappa=0.581)。结论 2017年ACR TI-RADS具有较高临床应用价值,鉴别甲状腺良恶性结节的最佳界值为5分。
英文摘要:
      Objective To explore the value of thyroid imaging report and data system (TI-RADS) recommended by American Radiology of Society (ACR) in 2017 for differentiating thyroid benign and malignant nodules. Methods Ultrasonic images of 497 thyroid nodules diagnosed with pathology were retrospectively analyzed using TI-RADS classification and given score and classification. The optimal critical score was determined with ROC curve, and the sensitivity, specificity and accuracy were calculated. The efficacy and consistency of senior and junior physicians in diagnosis of benign and malignant thyroid nodules using this optimal critical score were evaluated. Results The area under ROC curve was 0.883 (P<0.001), and the optimal critical score was 5, while the sensitivity and specificity was 86.22% and 78.68%, respectively. The sensitivity, specificity and accuracy of senior physicians in diagnosis of benign and malignant thyroid nodules was 78.22% (176/225), 76.47% (208/272) and 77.26% (384/497), of junior physicians was 77.33% (174/225), 74.26%(202/272) and 75.65% (376/497), respectively, and moderate consistency was found between senior and junior physicians (Kappa=0.581). Conclusion TI-RADS recommended by ACR in 2017 has high clinical value, and the optimal critical score for diagnosing benign and malignant thyroid nodule is 5.
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