超声甲状腺影像报告与数据系统及超声积分法对甲状腺结节的诊断价值

摘要

Objective To investigate the value of ultrasound thyroid imaging reporting and data system (TI-RADS)and ultrasonographic scoring system in the diagnosis of thyroid nodules.Methods The ultrasound data of 480 thyroid nodules confirmed by pathology were analyzed retrospectively.The receiver operative curve is used to evaluate the diagnostic performance of TI-RADS,ultrasonographic scoring system and their combination.Results The areas under the curves of TI-RADS and ultrasonographic scoring system were 0.897 and 0.934 respectively.The specificity and precision of ultrasonographic scoring system (83.1％and 86.7％) were higher than those of TI-RADS (80.2％ and 85.2 ％).The sensitivity,specificity,positive predictive value,negative predictive value and precision of combined application of both (92.4％,85.5％,86.3％,92.0％,89.0％) were higher than those of TI-RADS and ultrasonographic scoring system.Conclusions Ultrasound TI-RADS and ultrasonographic scoring system were useful in the differential diagnosis of thyroid nodules.Ultrasonographic scoring system should be further identified for suspected thyroid malignant nodules.Combined application is more effective in evaluating thyroid carcinoma.%目的 探讨超声甲状腺影像报告与数据系统(TI-RADS分级)及超声积分法对甲状腺癌的诊断价值.方法 回顾性分析经手术病理证实的480个甲状腺结节.以病理结果作为金标准构建ROC曲线,比较超声TI-RADS分级、超声积分法及二者联合对甲状腺癌的诊断价值.结果 超声TI-RADS分级与超声积分法的ROC曲线下面积分别为0.897、0.934.超声积分法诊断甲状腺癌的特异度和准确度为83.1％和86.7％均高于超声TI-RADS分级的80.2％和85.2％.二者联合诊断甲状腺癌的灵敏度、特异度、阳性预测值、阴性预测值、准确度均高于前两者,分别为92.4％、85.5％、86.3％、92.0％、89.0％.结论 超声TI-RADS分级与超声积分法对甲状腺结节的性质判断均具有较好的提示作用,超声积分法对于可疑甲状腺恶性结节可进一步识别.二者联合对评估甲状腺癌效能更高.