摘要
目的:对比2011年Kwak版甲状腺影像报告和数据系统(Thyroid Imaging Reporting and Data System,TIRADS),2015年美国甲状腺协会(American Thyroid Association,ATA)《成人甲状腺结节与分化型甲状腺癌指南》(ATA指南),2017年美国放射学会(American College of Radiology,ACR)TI-RADS及2020年中华医学会超声医学分会发布的《2020甲状腺结节恶性危险分层的中国指南:C TI-RADS》这4种甲状腺结节分级系统对儿童甲状腺良恶性结节的诊断效能。方法:收集2008年1月1日—2021年12月31日在复旦大学附属儿科医院超声科行超声检查并经甲状腺穿刺活检或术后病理学检查确诊的80例甲状腺结节患儿,根据Kwak TI-RADS、ATA指南、ACR TI-RADS以及C TI-RADS对甲状腺结节超声图像进行回顾性分级,以最终病理学检查结果为金标准,计算不同风险分层的恶性百分比,并绘制受试者工作特征(receiver operating characteristic,ROC)曲线,比较这4种分级系统ROC曲线的曲线下面积(area under curve,AUC)、诊断灵敏度及特异度。结果:ATA指南、Kwak TI-RADS、ACR TI-RADS及C TI-RADS的灵敏度分别为85.7%、74.3%、71.4%及77.1%,特异度分别为64.4%、66.7%、80.0%及69.3%,AUC分别为0.764、0.772、0.809及0.770。这4种检测方法对儿童甲状腺结节均具有较高的诊断效能,其中ACR TI-RADS诊断效能稍高于其他3种指南(P<0.05)。这4种检查方法的最佳截断值分别为ACR TI-RADS 4级,Kwak TI-RADS 4c,ATA指南中的高度可疑恶性以及C TI-RADS中的4C(高度可疑恶性)。结论:将4种成人甲状腺超声风险评级标准应用于儿童,均有较好的诊断效能,其中ACR TI-RADS诊断效能高于其他3种。
Objective:To compare the diagnostic efficacy of 2011 Kwak Thyroid Imaging Report and Data System(TI-RADS),2015 American Thyroid Association(ATA)guidelines for Adult thyroid nodules and differentiated thyroid cancer(ATA guidelines),2017 American College of Radiology(ACR)TI-RADS and 2020 China guidelines for malignant risk stratification of thyroid nodules:C TI-RADS issued by the Ultrasonic Medical Branch of Chinese Medical Association in 2020,these four thyroid nodule grading systems,in children with benign and malignant thyroid nodules.Methods:A retrospective analysis was conducted on 80 pediatric patients with thyroid nodules who underwent thyroid ultrasound examinations in Children’s Hospital of Fudan University between January 1,2008,and December 31,2021.These patients also underwent thyroid fine-needle aspiration biopsy or surgical treatment to confirm pathological results.Thyroid nodules were retrospectively graded based on the Kwak TI-RADS,ATA guidelines,ACR TI-RADS,and C TI-RADS.The final pathological results were used as the gold standard.Malignancy rates for different risk stratifications were calculated,and receiver operating characteristic(ROC)curves were plotted to compare the area under curve(AUC),diagnostic sensitivity,and specificity of these four grading systems.Results:The sensitivity of ATA guidelines,Kwak TI-RADS,ACR TI-RADS,and C TI-RADS were 85.7%,74.3%,71.4%,and 77.1%,respectively.The specificity were 64.4%,66.7%,80.0%,and 69.3%,respectively.The AUC values were 0.764,0.772,0.809,and 0.770,respectively.All 4 grading systems demonstrated relatively high diagnostic performance for pediatric thyroid nodules,with ACR TI-RADS having slightly higher diagnostic performance compared to the other three guidelines(P<0.05).The optimal cutoff values for these four methods were ACR TI-RADS 4,Kwak TI-RADS 4c,highly suspicious for malignancy in ATA guidelines,and 4C(highly suspicious for malignancy)in C TIRADS.Conclusion:Applying the four adult thyroid ultrasound risk stratification criteria to children demonstrates good diagnostic performance,with ACR TI-RADS exhibiting higher diagnostic performance compared to the other three methods.
作者
高文会
孙颖华
GAO Wenhui;SUN Yinghua(Department of Ultrasound,Children’s Hospital of Fudan University,Shanghai 201102,China)
出处
《肿瘤影像学》
2024年第3期276-281,共6页
Oncoradiology
