甲状腺结节TI-RADS分级与病理结果对照分析

摘要

目的 通过与病理结果对照,探讨甲状腺超声影像和数据报告系统(TI-RADS)在甲状腺结节分级中的应用.方法 回顾性分析2014年3月~2016年2月在我院就诊的357例甲状腺结节患者的临床资料,以及超声TI-RADS分级和穿刺活检病理结果等资料.比较甲状腺良、恶性结节的超声征象;与穿刺活检病理对照,采用受试者工作曲线(ROC)评价超声TI-RADS分级对甲状腺良、恶性结节的临床诊断效能.结果 531个结节,经穿刺病理诊断良性结节225个,恶性结节306个;超声TI-RADS分级诊断良性结节174个,恶性结节357个.超声TI-RADS分级诊断甲状腺良、恶性结节的ROC曲线下面积0.903、灵敏度95.82%(321/335)、特异度81.63%(160/196)、准确度90.58%(481/531)、阳性预测值89.91%(321/357)、阴性预测值91.95%(160/174)、阳性似然比5.22、阴性似然比0.05、Youden指数0.775.甲状腺良、恶性结节超声征象在边界、纵横比、回声类型和微小钙化等方面比较存在统计学差异(P<0.01).结论 超声TI-RADS分级对甲状腺良、恶性结节的诊断具有较高的临床应用价值,恶性结节边界不规则,纵横比≥1、以低/极低回声为主、常见微小钙化.%Objective To investigate the application of thyroid imaging reporting and data system (TI-RADS) in identifying benign and malignant thyroid nodules. Methods Clinical data of 357 patients with thyroid nodules in our hospital from March 2014 to February 2016 were analyzed retrospectively. The results of TI-RADS and pathologic examination were analyzed. The ultrasonographic features of benign and malignant thyroid nodules were compared. The clinical diagnostic efficacy of TI-RADS in identifying benign and malignant thyroid nodules were evaluated by using receiver operating curve (ROC). Results 225 benign nodules and 306 malignant nodules were diagnosed by pathologic examination, 174 benign nodules and 357 malignant nodules were diagnosed by TI-RADS. The AUC area of TI-RADS in identifying benign and malignant thyroid nodules was 0.903. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and Youden index of TI-RADS were 95.82%(321/335), 81.63%(160/196), 90.58%(481/531), 89.91%(321/357), 91.95%(160/174), 5.22, 0.05 and 0.775. There were statistically significant differences in morphology, aspect ratio, echo type and micro calcification between benign and malignant thyroid nodules (P<0.05). Conclusion TI-RADS has high clinical application value in identifying benign and malignant thyroid nodules.