Title2017版甲状腺影像报告和数据系统诊断甲状腺良恶性结节的价值
Other TitlesValue of 2017thyroid imaging reporting and data system in diagnosis of benign and malignant thyroid nodules
Authors梁振威
陈路增
王彬
张惠
邵玉红
孙秀明
陈铭
Affiliation北京大学第一医院超声诊断中心
Keywords甲状腺结节
超声检查
甲状腺影像报告和数据系统
thyroid nodule
ultrasonography
thyroid imaging reporting and data system
Issue Date2019
Publisher中国介入影像与治疗学
Abstract目的探讨2017版美国放射学院甲状腺影像报告和数据系统(TI-RADS)在评估甲状腺良恶性结节中的价值。方法采用2017版TI-RADS分类诊断标准,回顾性分析1 039例患者共1 109个甲状腺结节的声像图特征;以粗针穿刺活检或手术病理学结果为金标准,评价2017版TI-RADS对不同类别结节的诊断效能。结果良性结节551个,恶性结节558个;良恶性结节的成分、回声类型、纵横比、边界、有无钙化差异均有统计学意义(P均<0.05)。TI-RADS 2~5类结节中,恶性率分别为0、5.45%(3/55)、22.29%(39/175)和58.84%(516/877),差异有统计学意义(P<0.001)。以TI-RADS分类≥4为标准,诊断甲状腺恶性结节的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为99.46%(555/558)、9.80%(54/551)、54.91%(609/1 109)、52.76%(555/1 052)和94.74%(54/57)。结论根据2017版TI-RADS分类评估恶性甲状腺结节具有临床应用价值,但特异度较低,分类标准尚需进一步完善。
Objective To explore the value of 2017 thyroid imaging reporting and data system(TI-RADS)suggested by American College of Radiology in diagnosis of benign and malignant thyroid nodules.Methods According to 2017 TIRADS,the sonographic features of 1 109 pathologically diagnosed thyroid nodules in 1 039 patients were retrospectively analyzed.Taken coarse needle biopsy or surgical pathology as the gold standards,the diagnostic efficacy of 2017 TI-RADS for different types of nodules was analyzed.Results Of 1 109 nodules,551 were benign and 558 were malignant.The composition,echogenicity,aspect ratio,boundary and calcification were statistically different between benign and malignant nodules(all P<0.05).The probability of malignancy in nodules with a classification of TI-RADS 2,3,4 and 5 was 0,5.45%(3/55),22.29%(39/175)and 58.84%(516/877),respectively,which had statistical difference(P<0.001).When TI-RADS classification were larger than 4,the diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value was 99.46%(555/558),9.80%(54/551),54.91%(609/1 109),52.76%(555/1 052)and 94.74%(54/57),respectively.Conclusion 2017 TI-RADS classification is based on the morphology and maximum diameter management of thyroid nodules,demonstrating clinical application value in evaluating malignant nodules,but the specificity is low,therefore needing further improvement.
URIhttp://hdl.handle.net/20.500.11897/560726
ISSN1672-8475
DOI10.13929/j.1672-8475.201808045
Indexed中文核心期刊要目总览(PKU)
Appears in Collections:第一医院

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