TI-RADS分类系统在甲状腺结节诊断中的应用价值
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摘要
目的:探讨甲状腺超声影像和数据报告系统(TI-RADS)对于鉴别甲状腺结节性质的应用价值。方法:回顾性分析178例患者共295个结节的临床资料,逐一对结节的超声特征进行分析记录,运用TI-RADS分类方法对结节进行分类,同病理结果进行比较。结果:TI-RADS分类诊断良性结节共154个(2、3、4a类),恶性结节141个(4b、4c、5类)。病理确定恶性结节117个,其中2类0个、3类2个,4a类17个,4b类46个,4c类29个,5类23个。TI-RADS分类诊断甲状腺结节的灵敏度为90.6%,特异度为80.3%,准确率为84.4%,阳性预测值为75.2%,阴性预测值为92.9%。结论:TI-RADS分类系统在甲状腺结节的良恶性诊断中具有较高的诊断价值,对甲状腺患者治疗方式的选择具有很高的指导意义。
Objective:To explore the application value of thyroid imaging reporting and data system(TI-RADS) in diagnosis of thyroid nodules.Methods:The clinical data of 178 patients including 295 nodules were retrospectively analyzed.The sonographic characteristics of each nodule were analyzed and recorded.The nodule classification was performed using the TI-RADS classification and compared with the pathological results.Results:There were 154 benign nodules diagnosed by TI-RADS(classes 2,3,and 4 a) and 141 malignant nodules(class 4 b,4 c,and 5).Pathologically,117 malignant nodules were identified,including 0 of 2,2 of 3,17 of 4 a,46 of 4 b,29 of 4 c,and 23 of 5.The sensitivity of TI-RADS classification in the diagnosis of thyroid nodule was 90.6%.The specificity was 80.3%.The accuracy rate was 84.4%.The positive predictive value was 75.2%,and the negative predictive value was 92.9%.Conclusion:The TI-RADS classification system has high diagnostic value in the diagnosis of thyroid nodules,and has a high guiding significance for the selection of treatment methods for thyroid patients.
Objective:To explore the application value of thyroid imaging reporting and data system(TI-RADS) in diagnosis of thyroid nodules.Methods:The clinical data of 178 patients including 295 nodules were retrospectively analyzed.The sonographic characteristics of each nodule were analyzed and recorded.The nodule classification was performed using the TI-RADS classification and compared with the pathological results.Results:There were 154 benign nodules diagnosed by TI-RADS(classes 2,3,and 4 a) and 141 malignant nodules(class 4 b,4 c,and 5).Pathologically,117 malignant nodules were identified,including 0 of 2,2 of 3,17 of 4 a,46 of 4 b,29 of 4 c,and 23 of 5.The sensitivity of TI-RADS classification in the diagnosis of thyroid nodule was 90.6%.The specificity was 80.3%.The accuracy rate was 84.4%.The positive predictive value was 75.2%,and the negative predictive value was 92.9%.Conclusion:The TI-RADS classification system has high diagnostic value in the diagnosis of thyroid nodules,and has a high guiding significance for the selection of treatment methods for thyroid patients.
引文
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[8] Zhu Z,Xu XY,Gu GJ,et al.Diagnostic value of ultrasound-guided fine-needle aspiration biopsy for thyroid nodules[J].Chinese Journal of Ultrasonograhpy,2014,23(12):1088-1089.
[9] Yan JM,Huang PT,You XD,et al.Diagnostic value of contrast-enhanced ultrasound and fine needle aspiration in thyroid cancer[J].Chinese Journal of Ultrasonograhpy,2014,23(3):222-226.
[10] Liu L.The supersonic radiography diagnoses at the thyroid cancer the application present situation and the prospect[J].China & Foreign Medical Treatment,2015,34(15):175-176.
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[12] Campoy-Balbontin F,Jurado-Gómez C,Amador-Gil A.Benign and malignant thyroid nodules:Us differentiation-prospective study[A].Radiological Society of North America 2011 Scientific Assembly and Annual Meeting[C].Phoenix,Arizona:The Metal-lurgy Society,Inc,2011:71-74.
[13] Horvath E,Majlis S,Rossi R,et al.An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management[J].J Clin Endocrinol Metab,2009,94(5):1748-1751.
[14] Kwak JY,Han KH,Yoon JH,et al.Thyroid imaging reporting and data system for US features of nodules:A step in establishing better stratification of cancer risk[J].Radiology,2011,260(3):892-899.
[2] Haugen BR,Alexander EK,Bible KC,et al.2015 american thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer:The American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer[J].Thyroid,2016,26(1):1-133.
[3] Yue LX,Chen Q.Consensus and problems of thyroid imaging reporting and data system[J].Journal of Clinical Ultrasound Medicine,2016,18(03):185-188.
[4] Russ G,Bonnema SJ,Erdogan MF,et al.European thyroid association guidelines for ultrasound malignancy risk stratification of thyroid nodules in adults:The EU-TIRADS[J].Eur Thyroid J,2017,6(5):225-237.
[5] Baskin HJ.Ultrasound of thyroid nodules[J].Neuroimaging Clinics of North America,2008,18(3):463-478.
[6] Macedo BM,Izquierdo RF,Golbert L,et al.Reliability of thyroid imaging reporting and data system(TI-RADS),and ultrasonographic classification of the American thyroid association(ATA) in differentiating benign from malignant thyroid nodules[J].Arch Endocrinol Metab,2018,62(2):131-138.
[7] Dietrich CF,Bojunga J.Ultrasound of the thyroid[J].Laryngorhinootologie,2016,95(2):87-104.
[8] Zhu Z,Xu XY,Gu GJ,et al.Diagnostic value of ultrasound-guided fine-needle aspiration biopsy for thyroid nodules[J].Chinese Journal of Ultrasonograhpy,2014,23(12):1088-1089.
[9] Yan JM,Huang PT,You XD,et al.Diagnostic value of contrast-enhanced ultrasound and fine needle aspiration in thyroid cancer[J].Chinese Journal of Ultrasonograhpy,2014,23(3):222-226.
[10] Liu L.The supersonic radiography diagnoses at the thyroid cancer the application present situation and the prospect[J].China & Foreign Medical Treatment,2015,34(15):175-176.
[11] Moon WJ,Jung SL,Lee JH,et al.Benign and malignant thyroid nodules:US differentiation-multicenter retrospective study[J].Radiology,2008,247(3):762-770.
[12] Campoy-Balbontin F,Jurado-Gómez C,Amador-Gil A.Benign and malignant thyroid nodules:Us differentiation-prospective study[A].Radiological Society of North America 2011 Scientific Assembly and Annual Meeting[C].Phoenix,Arizona:The Metal-lurgy Society,Inc,2011:71-74.
[13] Horvath E,Majlis S,Rossi R,et al.An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management[J].J Clin Endocrinol Metab,2009,94(5):1748-1751.
[14] Kwak JY,Han KH,Yoon JH,et al.Thyroid imaging reporting and data system for US features of nodules:A step in establishing better stratification of cancer risk[J].Radiology,2011,260(3):892-899.