C-TIRADS与ACR-TIRADS在甲状腺结节诊断效能中的对比分析
Comparative analysis of C-TIRADS and ACR-TIRADS in the diagnostic efficiency of thyroid nodules
摘要目的:对比2020年中国超声甲状腺影像报告和数据系统(C-TIRADS)与2017年美国放射学会甲状腺影像报告和数据系统(ACR-TIRADS)在甲状腺良恶性结节中的诊断效能。方法:回顾分析2018年1月至2019年1月在广东省第二人民医院健康管理科体检时超声发现甲状腺结节并行甲状腺结节手术的289例患者共324个甲状腺结节的二维超声图像结果,由一名浅表专业方向的高级职称医师同时运用C-TIRADS和ACR-TIRADS方法对上述结节进行评估,结果均以病理为参照标准进行χ2检验及绘制受试者工作特征(ROC)曲线进行分析。结果:C-TIRADS诊断甲状腺结节良恶性的灵敏度为81.90%、特异度为97.72%、准确性为92.59%、阴性预测值为91.85%、阳性预测值为84.51%;ACR-TIRADS诊断甲状腺结节良恶性的灵敏度为59.05%、特异度为99.54%、准确性为86.42%、阴性预测值为83.52%、阳性预测值为98.41%。获得ROC曲线下面积分别为0.958和0.935( Z=2.31, P=0.021)。 结论:基于计数法的C-TIRADS分类较赋分法的ACR-TIRADS分级在甲状腺结节的诊断效能更佳,更适合目前中国甲状腺结节诊疗现状。
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abstractsObjective:To investigate the diagnostic efficiency of the 2020 Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) and the 2017 American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) in the diagnosis of benign and malignant thyroid nodules.Methods:A retrospective analysis of the two-dimensional ultrasound image results of 324 thyroid nodules in 289 patients with thyroid nodules and thyroid nodules were performed in the physical examination of the Health Management Department of the Guangdong Second Provincial General Hospital from January 2018 to January 2019. A superficial professional doctor with a senior professional title simultaneously uses the C-TIRADS and ACR-TIRADS methods to evaluate the above nodules. The results are all pathologically referenced for the χ2 test and the receiver operating characteristic curve is drawn. Results:The sensitivity of C-TIRADS in diagnosing benign and malignant thyroid nodules was 81.90%, specificity was 97.72%, accuracy was 92.59%, negative predictive value was 91.85%, positive predictive value was 84.51%; ACR-TIRADS diagnosis The sensitivity of benign and malignant thyroid nodules was 59.05%, specificity was 99.54%, accuracy was 86.42%, negative predictive value was 83.52%, and positive predictive value was 98.41%. The area under the ROC curve was 0.958 and 0.935( Z=2.31 P=0.021). Conclusion:C-TIRADS classification based on counting method is better than ACR-TIRADS classification based on sub-method in the diagnosis of thyroid nodules. It has better efficacy and is more suitable for the current status of diagnosis and treatment of thyroid nodules in China.
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