摘要
目的探讨由美国放射学会(ACR)提出的甲状腺成像报告和数据系统(TI-RADS)在甲状腺结节诊断中的临床应用价值。方法选取2019年1月至12月在首都医科大学大兴教学医院超声科行超声检查并最终获得病理结果的110例甲状腺结节患者(118个结节)为研究对象,观察118个结节的二维声像图特征,根据ACR TI-RADS分类标准统计ACR TI-RADS分类,绘制受试者操作特征(ROC)曲线,观察其对≥1 cm及<1 cm结节的诊断价值。结果118个结节中,良性73个,恶性45个。45个恶性结节中全部(100%)表现为实性;43个表现为低回声或极低回声,仅2个表现为等回声;31个表现为纵横比>1;30个边缘不规则,3个向甲状腺外侵犯;22个伴点状钙化,3个伴粗大钙化。118个甲状腺结节中TI-RADS 2类26个;3类7个;4类32个;5类53个。ACR TI-RADS分类诊断≥1 cm结节良恶性的临界值为6.5分,曲线下面积为0.935,灵敏度和特异度为88.9%、87.0%;ACR TI-RADS分类诊断<1 cm结节良恶性的临界值为6.5分,曲线下面积为0.725,灵敏度和特异度为92.6%、40.7%。结论ACR TI-RADS分类对于≥1 cm甲状腺结节良恶性诊断的准确性较高,对于<1 cm结节诊断准确性中等,临床决策时需要参考。
Objective To explore the application value of American College of Radiology(ACR)thyroid imaging reporting and data system(TI-RADS)in diagnosising of thyroid nodules.Methods A total of 110 patients with thyroid nodules(118 nodules)who received ultrasound examination and obtained pathological results in the Department of Ultrasound,Daxing Teaching Hospital of Capital Medical University from January to December 2019 were selected as the research objects.Two-dimensional ultrasonographic characteristics of 118 nodules were observed,according to ACR TI-RADS classification criteria,the ACR TI-RADS classification was counted and the receiver operating characteristic(ROC)curve was drawn to observe its diagnostic value for nodules≥1 cm and<1 cm.Results Of the 118 nodules,73 were benign and 45 were malignant.All(100%)of 45 malignant nodules were solid;43 nodules showed low echo or very low echo,and only 2 nodules showed isechoic;31(68.9%)nodules showed aspect ratio>1;30 nodules had irregular margins,and 3 nodules had extrinsic thyroid invasion;22 nodules with punctal calcification and 3 nodules with extensive calcification.Among 118 thyroid nodules,26 nodules were TI-RADS 2;7 nodules was TI-RADS 3;32 nodules was TI-RADS 4;53 nodules was TI-RADS 5.The critical value of ACR TI-RADS for benign and malignant nodules≥1 cm was 6.5 points,the area under the curve was 0.935,and the sensitivity and specificity were 88.9%and 87.0%;The critical value of ACR TI-RADS classification for benign and malignant nodules<1 cm was 6.5 points,the area under the curve was 0.725,and the sensitivity and specificity were 92.6%and 40.7%.Conclusion ACR TI-RADS classification has high accuracy in benign and malignant diagnosis of≥1 cm thyroid nodule,and medium accuracy in diagnosis of<1 cm thyroid nodule,which should be referred to in clinical decision making.
作者
冯伶艳
肖保军
FENG Lingyan;XIAO Baojun(Department of Ultrasound,Daxing Teaching Hospital of Capital Medical University,Beijing 102600,China)
出处
《中国医药导报》
CAS
2022年第16期151-155,共5页
China Medical Herald
基金
北京市卫生健康委员会科技项目(BHTPP202024)。
关键词
超声检查
甲状腺成像报告与数据系统
甲状腺结节
美国放射学会
Ultrasound examination
Thyroid imaging reporting and data system
Thyroid nodule
American College of Radiology
