甲状腺超声影像和数据报告系统在不同性别和年龄甲状腺结节患者中的诊断价值

Impact of age and gender on ultrasound imaging and TI-RADS stratification in patients with thyroid nodules

目的 探讨甲状腺超声影像和数据报告系统（TI-RADS）在诊断不同性别和年龄甲状腺结节患者中的应用价值。方法 收集684例甲状腺结节患者，其中男性118例，女性566例，分别对不同性别和年龄的甲状腺结节患者进行TI-RADS分级，并与病理结果比较，进行诊断性分析。结果 TI-RADS分级诊断男性恶性甲状腺结节的敏感度为84.7%，特异度为66.7%，曲线下面积（AUC）为0.803（95% CI为0.709-0.897）。TI-RADS分级诊断女性恶性甲状腺结节的敏感度为80.8%，特异度为65.0%，AUC为0.812（95% CI为0.758-0.849）。TI-RADS判断不同性别甲状腺结节性质的差异无统计学意义（P〉0.05）。TI-RADS分级诊断26-35岁恶性甲状腺结节的敏感度为85.4%，特异度为90.0%，AUC为0.915（95%CI为0.818-0.987）。TI-RADS分级诊断36-45岁恶性甲状腺结节的敏感度为84.4%，特异度为78.1%，AUC为0.898（95%CI为0.842-0.953）；TI-RADS分级诊断46-55岁恶性甲状腺结节的敏感度为79.7%，特异度为71.4%，AUC为0.822（95%CI为0.789-0.925）；TI-RADS分级诊断56-65岁恶性甲状腺结节的敏感度为75.6%，特异度为60.0%，AUC为0.729（95%CI为0.576-0.785）。56-65岁组患者的ROC曲线与26-35岁组、36-45岁组、46-55岁组差异均有统计学意义（均P〈0.05）。结论 患者性别并未对TI-RADS的分级诊断产生影响，而患者的年龄能够对TI-RADS的分级诊断产生影响。利用TI-RADS进行甲状腺结节的超声诊断应考虑患者年龄因素。

Objective To explore the application value of Thyroid Imaging Reporting and Data System （TI-RADS） stratification in diagnosing thyroid nodules in respect of the effect of age and gender. Methods A total of 684 patients with thyroid nodules, including 118 males and 566 females, were stratified into subgroups according to their age and gender, and the results of TI-RADS evaluation were compared with their pathological diagnosis. Results The sensitivity, specificity, and AUC of TI-RADS grading for malignant thyroid nodules in the males was 84.7%, 66.7%, and 0.803 （95% CI 0.709-0.897）, respectively. In the females, the sensitivity and specificity were 80.8% and 65.0%, respectively, with an AUC of 0.812 （95% CI 0.758-0.849）. There was no statistically significant difference between genders when using TI-RADS to determine the nature of thyroid nodules （P〉0.05）. In the patients aged 26-35 years, the sensitivity, specificity and AUC of TI-RADS classification for malignant thyroid nodules were 85.4%, 90.0%, and 0.915 （95% CI 0.818-0.987）, respectively. In the patients aged 36-45 years, the sensitivity and specificity of TI-RADS classification for malignant thyroid nodules were 84. 4% and 78. 1%, respectively, with an AUC of 0. 898 （95% CI 0.842-0.953）. In the patients aged 46-55 years, the corresponding parameters were 79.7%, 71.4% and AUC 0.822 （95% CI 0.789-0.925）, respectivey, while in those aged 56-65 years, the corresponding data were 75.6%, 60.0%, and AUC 0.729 （95% CI 0.576- 0.785 ）, respectively. The ROC curve of patients aged 56-65 years was statistically significantly different from those of patients aged 26-35, 36-45 and 46-55 years （P〈0.05 for all）. Conclusions Patient gender has no significant effect on the results of TI-RADS classification, but age of the patients does. The age factor should be considered during ultrasound diagnosis of thyroid nodules using TI-RADS classification.