文章摘要
季 沁,陈国芳,褚晓秋,周一帆,陈 茉,丁文波,胡 欣,相萍萍,武心萍,王建华,徐书杭,刘 超.3种甲状腺结节超声报告系统诊断效能的比较研究[J].南京医科大学学报,2019,(3):408~413
3种甲状腺结节超声报告系统诊断效能的比较研究
Comparison of diagnostic efficacy among three ultrasound reporting systems in diagnosis of thyroid nodules
投稿时间:2018-06-19  
DOI:10.7655/NYDXBNS20190320
中文关键词: 甲状腺结节  超声模型  甲状腺成像报告和数据系统  诊断效能
英文关键词: thyroid nodules  sonographic pattern  thyroid imaging reporting and data system  diagnostic efficacy
基金项目:江苏省“六大人才高峰”项目(2013?WSN?063);中国中医科学院江苏分院院级课题(JSBY1301,BJ18029)
作者单位
季 沁 南京中医药大学附属中西医结合医院(江苏省中西医结合医院、江苏省中医药研究院)普外科江苏 南京 210008 
陈国芳 南京中医药大学附属中西医结合医院(江苏省中西医结合医院、江苏省中医药研究院)内分泌科江苏 南京 210008 
褚晓秋 南京中医药大学附属中西医结合医院(江苏省中西医结合医院、江苏省中医药研究院)内分泌科江苏 南京 210008 
周一帆 南京中医药大学附属中西医结合医院(江苏省中西医结合医院、江苏省中医药研究院)普外科江苏 南京 210008 
陈 茉 南京中医药大学附属中西医结合医院(江苏省中西医结合医院、江苏省中医药研究院)内分泌科江苏 南京 210008 
丁文波 南京中医药大学附属中西医结合医院(江苏省中西医结合医院、江苏省中医药研究院)超声科江苏 南京 210008 
胡 欣 南京中医药大学附属中西医结合医院(江苏省中西医结合医院、江苏省中医药研究院)内分泌科江苏 南京 210008 
相萍萍 南京中医药大学附属中西医结合医院(江苏省中西医结合医院、江苏省中医药研究院)内分泌科江苏 南京 210008 
武心萍 南京中医药大学附属中西医结合医院(江苏省中西医结合医院、江苏省中医药研究院)超声科江苏 南京 210008 
王建华 南京中医药大学附属中西医结合医院(江苏省中西医结合医院、江苏省中医药研究院)普外科江苏 南京 210008 
徐书杭 南京中医药大学附属中西医结合医院(江苏省中西医结合医院、江苏省中医药研究院)内分泌科江苏 南京 210008 
刘 超 南京中医药大学附属中西医结合医院(江苏省中西医结合医院、江苏省中医药研究院)内分泌科江苏 南京 210008 
摘要点击次数: 341
全文下载次数: 94
中文摘要:
      目的:通过回顾性研究,比较并验证美国甲状腺学会(ATA)指南推荐的超声模型(ATA超声模型)、韩国甲状腺放射学会和美国放射学会分别提出的甲状腺成像报告和数据系统(K?TIRADS、ACR?TIRADS)对甲状腺结节良恶性鉴别的诊断效能。方法:选取2012年1月—2017年10月在江苏省中西医结合医院行甲状腺超声检查并住院完成手术治疗的765例甲状腺结节患者,共1 065个结节,收集患者一般资料和结节的超声特征,分别按照3种超声诊断模型分级。构建受试者工作曲线,并根据约登指数选取最佳诊断切点,比较它们的诊断效能。结果:术后病理证实,1 065个结节中良性388个(36.43%),恶性677个(63.57%)。存在实性、极低回声或低回声、不规则边缘、微钙化和纵横比>1等超声特征的结节恶性率较高。ATA超声模型由低度可疑到高度可疑的恶性率分别为2.99%、23.53%、69.23%和93.37%,K?TIRADS 3级到5级的恶性率分别为13.33%、48.64%、95.91%,ACR?TIRADS 2级到5级的恶性率分别为3.36%、13.22%、56.09%、91.16%,各超声模型中各类别具有统计学意义(P<0.001)。另外,ATA超声模型中有18.4%的结节无法归入任何一个分类,恶性率达到44.90%。ACR?TIRADS的灵敏度与阴性预测值高于K?TIRADS和ATA超声模型。结论:3种超声报告系统对甲状腺结节的诊断均具有一定临床应用价值。部分结节无法被ATA超声模型分类,TIRADS更值得临床进一步研究与应用。
英文摘要:
      Objective:To compare the diagnostic efficacy of sonographic pattern from American Thyroid Association(ATA)Management Guidelines,thyroid imaging reporting and data system from Korean Society of Thyroid Radiology(K?TIRADS)and American College of Radiology(ACR?TIRADS)in diagnosis of thyroid nodules. Methods:From January 2012 to October 2017,756 patients with 1 065 thyroid nodules underwent preoperatively thyroid ultrasonographic examination and operation in Jiangsu Province Hospital on Integration of Chinese and Western Hospital. The general information of patients and ultrasound features of their thyroid nodules were collected. All nodules were categorized based on ATA sonographic pattern,K?TTIRADS and ACR?TIRADS. The receiver operating characteristic curve(ROC)curve was constructed,and the best diagnostic cut?off was selected according to the Youden index to compare their diagnostic performance. Results:Among 1 065 thyroid nodules,388 cases(36.43%)and 677 cases(63.57%)were confirmed to be benign and malignant by postoperative pathology,respectively. Ultrasound features including hypoechogenicity,solidity,microcalcification,irregular margin and aspect ratio>1 had a higher rate of malignancy. The malignancy rates of each ATA sonographic pattern from low to high suspicious were 2.99%,23.53%,69.23% and 93.37%,respectively(P < 0.001). The malignancy rates of category 3,4 and 5 nodules made by K?TIRADS were 13.33%,48.64% and 95.91%,respectively(P < 0.001). The malignant rates of category 2,3,4 and 5 nodules made by ACR?TIRADS were 3.36%,13.22%,56.09% and 91.16%,respectively(P < 0.001). Surprisingly,18.4% of thyroid nodules could not be categorized into any ATA pattern,of which 44.9% were ultimately found to be malignant. The ACR?TIRADS had a higher sensitivity and negative predictive value compared to K?TIRADS and ATA sonographic pattern. Conclusion:Three ultrasound reporting systems have certain clinical application value for diagnosis of thyroid nodules. Due to a small proportion of thyroid nodules can’t be classified by ATA sonographic pattern,TIRADS is worthy of further clinical research and application.
查看全文   查看/发表评论  下载PDF阅读器
关闭