摘要
目的通过比较结合了超声弹性成像(UE)结果的甲状腺影像学报告及数据系统(Thyroid imaging reporting and data system,TI-RADS)与TI-RADS对甲状腺结节定性诊断的诊断效能,期望得到更好的甲状腺结节定性诊断方法。方法对手术病理证实的149例患者250个病灶行常规的超声检查,所有结节按TI-RADS分级进行评分,并按照UE的4分评分方法对所有结节进行评分,结合UE结果,对TI-RADS评分进行调整,得到新的评分方法,构建受试者应用曲线(ROC),评价两种诊断方法对甲状腺结节良、恶性鉴别的诊断价值。结果 TI-RADS诊断标准与结合UE后的新标准曲线下面积(AUC)分别为0.880、0.940,两者之间的差异有统计学意义(P<0.05),TI-RADS诊断标准的敏感性、特异性、准确性、阳性预测值、阴性预测值分别为72%、84%、82%、58%、91%;改良后的TI-RADS诊断标准敏感性、特异性、准确性、阳性预测值、阴性预测值分别为91%、92%、92%、76%、97%,两者之间的差异有统计学意义(P<0.05)。结论改良TI-RADS诊断标准对甲状腺结节良恶性鉴别有较高的诊断价值。
Objective To find a better method for diagnosis of thyroid nodules through comparing a combination of ultrasound elastography（UE） the results of thyroid imaging reporting and data system（Thyroid imaging reporting and data system,TI-RADS） and TI-RADS diagnosis of thyroid nodule.Methods 149 patients with 250 nodules were enrolled in the study.The pathologic diagnosis was as golden standard.All nodules by TI-RADS classification score,and score 4 points in accordance with the UE method to rate all the nodules,with UE results TI-RADS score of adjustment to get the new scoring method.The diagnostic performance of the 2 TI-RADS standards were evaluated with receiver operating characteristic curve（ROC）.Results The areas under the curve（AUC） of the 2 methods were TI-RADS 0.880,improved TI-RADS 0.940.The diagnostic performance of the improved TI-RADS was better than that of TI-RADS（P0.05）,TI-RADS diagnostic criteria of sensitivity,specificity,accuracy,positive predictive value,negative predictive value were 72%,84%,82%,58%,91% respetively;improved TI-RADS sensitivity,specificity,accuracy,positive predictive value,negative predictive value were 91%,92%,92%,76%,97% respetively.The difference between the two was statistically significant（P0.05）.Conclusion The improved TI-RADS diagnostic criteria for identification of benign and malignant thyroid nodules have a high diagnostic value.
出处
《延安大学学报（医学科学版）》
2011年第4期19-21,共3页
Journal of Yan'an University:Medical Science Edition
