摘要
目的比较ACR TI-RADS分类法与ATA分类法对判断甲状腺结节良恶性的诊断价值,以及不同诊断医师之间的一致性。方法回顾性分析454个甲状腺结节的超声图像,分别按2017年ACRTI-RADS标准和2015年ATA标准进行分类,结合病理结果,分析不同分类法对甲状腺结节的诊断价值。应用Kappa分析评价不同年资的3位超声医师之间的一致性。结果 ACR TI-RADS法与ATA分类法判断结节良恶性的敏感性、特异性、准确性分别为98.7%、59.8%、79.1%vs 98.2%、64.6%、81.2%;组间差异无统计学意义。两者ROC曲线下面积分别为0.79 vs 0.804。不同年资医师应用ACR的TI-RADS进行分类一致性极好κ=0.862,应用ATA标准进行分类一致性中等κ=0.583。结论 ACR TI-RADS与ATA分类法在评估甲状腺结节的良恶性方面诊断效能相当,但ACR TI-RADS在不同医师之间应用的一致性更好。
Objective To compare the diagnostic performance of ACR TI-RADS and ATA guidelines classification standards for thyroid nodules.Methods A total of 454 thyroid nodules that underwent ultrasonogra-phy were grouped into different category according to TI-RADS classification standard of ACR TI-RADS 2017 and 2015 ATA guideline classification standards.The results were retrospectively compared with histopathological to find the diagnosis value of different method.Kappa analysis was used to evaluate the consistency between the 3 ul-trasound doctors of different seniority.Results The sensitivity,specificity,accuracy of ACR TI-RADS and ATA guidelines classification standards in the diagnosis of benign and malignant thyroid nodules were 98.7%、59.8%、79.1%vs 98.2%、64.6%、81.2%(P>0.05).The difference of the classification between two methods was not statis-tically significant.According to the ROC curve analysis,the area under the curve of ACR TI-RADS and ATA guidelines classification standards were 0.79 vs 0.814(P>0.05).Different doctor can get good consistency(κ=0.862)by ACR TI-RADS,but mediate consistency(κ=0.583)by ATA guidelines.Conculsion ACR TI-RADS and ATA guidelines classification standards has the same diagnosis value in evaluating thyroid nodules.Different doctor can get better consistency by ACR TI-RADS.
作者
赵新保
罗艺
李世梅
智慧
郝少云
ZHAO Xinbao;LUO Yi;LI Shimei;ZHI Hui;HAO Shaoyun(Department of ultrasound in Medicine,the Sun Yat.sen Memorial Hospital of Sun Yat.senUniversity,Guangzhou 510120,China)
出处
《实用医学杂志》
CAS
北大核心
2018年第18期3118-3120,3129,共4页
The Journal of Practical Medicine
基金
广东省科技发展计划专项资金(编号:2017B020247015)
