摘要
目的评价Bethesda系统联合甲状腺超声影像报告与数据系统（TIRADS）对甲状腺结节恶性风险的评估价值。方法回顾性分析经TIRADS分类并行超声引导细针穿刺细胞学检查（US-FNAC）的243例患者273个甲状腺结节资料，将其超声分类及Bethesda分类与组织病理学结果对照，统计Bethesda分类独立诊断和联合TIRADS诊断的敏感性、特异性。结果Bethesda分类独立诊断的敏感性为91．0％、特异性为90．3％；FNAC未定性类别中，BethesdaⅠ、Ⅲ类恶性率38．7％，BethesdaⅣ、Ⅴ类恶性率85．4％。联合TIRADS，阳性结果的敏感性为82．4％、特异性为100％，阴性结果的敏感性为99．5％、特异性为83．8%；FNAC未定性类别中，BethesdaⅠ／Ⅲ类且TIRADS2／3a类、BethesdaⅠ／Ⅲ类且TIRADS3b／3c／4、BethesdaⅣ／Ⅴ类且TIRADS2／3a、BethesdaⅣ／Ⅴ类且TIRADS3b／3c／4类恶性率分别为3．7％、81．8％、45．4％、100％。结论Bethesda分类联合TIRADS有助于甲状腺结节的术前诊断，减少部分不必要的重复细针穿刺和过度手术治疗。
Objective To evaluate the diagnostic value of Bethesda system combined with thyroid imaging reporting and data system （TIRADS） in assessing the malignat risk of thyroid nodules. Methods Histopathological, cytological and ultrasound （US） data were studied retrospectively for 243 cases after surgery,including 273 thyroid nodules. All thyroid cytopathological slides and US reports were classified according to Bethesda system and TIRADS. Based on histopathological comparison, the sensitivity and specificity were determined for Bethesda category and Bethesda category combined with TIRADS. Results The sensitivity and specificity of Bethesda category were 91.0%and 90.3%, respectively. In indeterminate nodules, malignancy rate was 38.7% in Bethesda categories Ⅰ and Ⅲ , and 85.4% in Bethesda categories Ⅳ and Ⅴ. In contrast, combined with TIRADS, the sensitivity and specificity of positive results were 82.4%, 100%, and negative results were 99.5%, 83.8%, respectively. The malignancy rate of TIRADS 2/3a in Bethesda categories Ⅰ/Ⅲ, TIRADS 3b/3c/4 in Bethesda categoriesⅠ/Ⅲ, TIRADS 2/3a in Bethesda categories Ⅳ/Ⅴ, and TIRADS 3b/3c/4 in Bethesda categories Ⅳ/Ⅴ were 3.7%, 81.8%, 45.4% and 100%, respectively. Conclusions Bethesda system combined with TIRADS may be helpful to the preoperative diagnosis of thyroid nodules, which may reduce unnecessary repeat fine needle aspiration and excessive surgery.
出处
《中华超声影像学杂志》
CSCD
北大核心
2016年第8期710-714,共5页
Chinese Journal of Ultrasonography
基金
福建省科技重点项目（2014Y0026）
