甲状腺影像报告和数据系统在甲状腺结节良恶性超声诊断中的可行性分析
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摘要
目的探讨甲状腺影像报告和数据系统在甲状腺结节良恶性的超声诊断中的可行性。方法回顾性分析2017年4月～2018年10月行甲状腺结节手术的患者140例(共165个结节)的超声资料,其甲状腺术前超声征象及甲状腺影像报告和数据系统(TI-RADS)对甲状腺结节良恶性进行的风险评估,与术后病理对照。结果本研究与病理结果对照显示TI-RADS 2类、3类、4a类、4b类、4c类以及5类甲状腺结节中甲状腺癌的发生率分别为0.0%、4.1%、6.7%,67.8%,86.7%,100.0%,与恶性风险值相符合。若以TI-RADS 4b、4c、5类为恶性结节,TI-RADS 2、3、4a类为良性结节,进行统计学分析,其鉴别甲状腺结节良恶性的敏感度、特异度及准确率分别为91.3%、90.7%、90.9%。超声TI-RADS分类诊断的ROC曲线下面积为0.943。结论甲状腺影像报告和数据系统在甲状腺结节良恶性超声诊断中确切可行,诊断效果明显。
Objective To explore the feasibility of thyroid imaging reporting and data system in the diagnosis of benign and malignant thyroid nodules by ultrasonography. Methods A total of 165 nodules in 140 patients who underwent thyroid nodule surgery in our hospital from April 2017 to October 2018 were included in this retrospective study. The risk assessment of benign and malignant thyroid nodules by preoperative ultrasonographic signs and thyroid imaging reporting and data system(TI-RADS) was compared with postoperative pathology. Results The incidence of thyroid cancer in TI-RADS 2, 3, 4 a, 4 b, 4 c and 5 thyroid nodules was 0.0%, 4.1%, 6.7%, 67.8%, 86.7%, 100.0% respectively, which was consistent with the malignant risk. If TI-RADS 4 b, 4 C and 5 were malignant nodules and TI-RADS 2, 3 and 4 a were benign nodules, statistical analysis was made.the accuracy sensitivity and specificity of TIRADS in diagnosis of benign and malignant thyroid lesions were 91.3%, 90.7% and 90.9%,respectively. The area under ROC curve was 0.943. Conclusion Thyroid imaging reporting and data system is accurate and feasible in the diagnosis of benign and malignant thyroid nodules by ultrasonography. It has obvious diagnostic effect and is worthy of popularization and application.
Objective To explore the feasibility of thyroid imaging reporting and data system in the diagnosis of benign and malignant thyroid nodules by ultrasonography. Methods A total of 165 nodules in 140 patients who underwent thyroid nodule surgery in our hospital from April 2017 to October 2018 were included in this retrospective study. The risk assessment of benign and malignant thyroid nodules by preoperative ultrasonographic signs and thyroid imaging reporting and data system(TI-RADS) was compared with postoperative pathology. Results The incidence of thyroid cancer in TI-RADS 2, 3, 4 a, 4 b, 4 c and 5 thyroid nodules was 0.0%, 4.1%, 6.7%, 67.8%, 86.7%, 100.0% respectively, which was consistent with the malignant risk. If TI-RADS 4 b, 4 C and 5 were malignant nodules and TI-RADS 2, 3 and 4 a were benign nodules, statistical analysis was made.the accuracy sensitivity and specificity of TIRADS in diagnosis of benign and malignant thyroid lesions were 91.3%, 90.7% and 90.9%,respectively. The area under ROC curve was 0.943. Conclusion Thyroid imaging reporting and data system is accurate and feasible in the diagnosis of benign and malignant thyroid nodules by ultrasonography. It has obvious diagnostic effect and is worthy of popularization and application.
引文
[1]张波,姜玉新,李建初,等.超声在甲状腺结节手术决策中的作用:北京协和医院11年回顾[J].协和医学杂志,2015,6(2):124-127.
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[3]Department of Endocrinology,Royal Victoria Infirmary,Newcastleupon Tyne.et al.2009 American Thyroid Association guidelineson thyroid nodules[J].Clin Oncol,2010,22(6):469-471.
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[6]Cheng SP,Lee JJ,Lin JL,et al.Characterization of thyroid nodules using the proposed thyroid imaging reporting and data system(TI-RADS)[J]Head Neck,2013,35(4):541-547.
[7]张贺香,胡萍香,胡业深,等.TI-RADS分类量化评分在鉴别甲状腺结节良恶性中的应用[J].中国中西医结合影像学杂志,2017,15(3):300-304.
[2]中华医学会内分泌学分会,中华医学会外科学分会,中国抗癌协会头颈肿瘤专业委员会,等.甲状腺结节和分化型甲状腺癌诊治指南[J]中华核医学与分子影像杂志,2013,33(2):96-115.
[3]Department of Endocrinology,Royal Victoria Infirmary,Newcastleupon Tyne.et al.2009 American Thyroid Association guidelineson thyroid nodules[J].Clin Oncol,2010,22(6):469-471.
[4]Park CS,Kim SH,Jung NY,et al.Interobserver variability of ultrasoundelastography and the ultrasound BI-RADS lexicon of breast lesions[J].Breast Cancer,2015,,22(2):153-160.
[5]Kwak JY,Han KH,Yoon JH,et a1.Thyroid imaging reporting and data system for US features of nodules:a step in establishing better stratification of cancer risk[J].Radiology,201 1,260(3):892-899.
[6]Cheng SP,Lee JJ,Lin JL,et al.Characterization of thyroid nodules using the proposed thyroid imaging reporting and data system(TI-RADS)[J]Head Neck,2013,35(4):541-547.
[7]张贺香,胡萍香,胡业深,等.TI-RADS分类量化评分在鉴别甲状腺结节良恶性中的应用[J].中国中西医结合影像学杂志,2017,15(3):300-304.