摘要
目的:研究美国放射学会(ACR)甲状腺超声征象报告与数据系统(TI-RADS)在伴桥本甲状腺炎(HT)的甲状腺结节良恶性鉴别诊断的应用价值。方法:选取在医院诊治的190例伴有HT的甲状腺结节患者,均接受超声检查,并分别采用KwakTI-RADS和ACRTI-RADS分类标准记录超声诊断结果,比较两种分类标准鉴别诊断伴HT的甲状腺结节良性与恶性。结果:超声检查显示恶性甲状腺结节呈极低回声或点状强回声,结节出现微钙化或边缘环形钙化,形态不规则,纵横比>1。手术病理证实190例伴HT的甲状腺结节患者中共发现306个结节,其中182个结节为恶性,124个结节为良性。一致性检测中KwakTI-RADS分类标准与病理结果的Kappa值为0.836,ACRTI-RADS分类标准与病理结果的Kappa值为0.873。KwakTI-RADS分类标准与ACRTI-RADS分类标准对鉴别诊断伴HT的甲状腺结节性质的灵敏度、准确度及阴性预测值差异无统计学意义;ACRTI-RADS分类标准的特异度和阳性预测值较KwakTI-RADS显著提高,差异有统计学意义(x2=6.295,x2=5.082;P<0.05)。结论:ACRTI-RADS用于伴HT的良恶性甲状腺结节性质判断具有较高的特异性,有助于伴HT的恶性甲状腺结节被早期检出。
Objective:To study the application value of thyroid imaging reporting and data system(TI-RADS)of American college of radiology(ACR)in the differential diagnosis of benign and malignant thyroid nodules with Hashimoto’s thyroiditis(HT).Methods:190 patients with thyroid nodule who accompanied with HT were included as the research objects,and all patients underwent ultrasonography examination.And the results of ultrasonic diagnosis were recorded by the classification standards of Kwak TI-RADS and ACR TI-RADS,respectively.And the benign and malignant thyroid nodules with HT in the differential diagnosis between two kinds of standard of classification were compared.Results:The results of ultrasonic examination showed that the malignant thyroid nodules appeared very low echo or point-like strong echo,and the nodule of them appeared micro calcification or marginal ring calcification,and the shapes of these nodules were irregular,and the aspect ratio was larger than 1.182 malignant nodules and 124 benign nodules in the 306 thyroid nodules were confirmed in 190 patients with HT by surgical pathology.The results of consistency test showed that Kappa value between Kwak TI-RADS classification standard and pathological results was 0.836,and the Kappa value between ACR TI-RADS classification standard and pathological results was 0.873.There were no significant difference in sensitivity,accuracy and negative predictive value between Kwak TI-RADS and ACR TI-RADS for differential diagnosis of the nature of thyroid nodules with HT.The specificity and positive predictive value of ACR TI-RADS were significantly higher than those of Kwak TI-RADS(x2=6.295,x2=5.082,P<0.05).Conclusion:The ACR TI-RADS has higher specificity in the judgement on the nature of benign and malignant thyroid nodules with HT,and it is helpful for the early detection of malignant thyroid nodules with HT.
作者
张露
徐玮
戈冬青
张卉新
ZHANG Lu;XU Wei;GE Dong-qing(Department of Ultrasound,The Affiliated Huaian No.1 People’s Hospital Nanjing Medical University,Huaian 223300,China)
出处
《中国医学装备》
2020年第12期72-75,共4页
China Medical Equipment
