TI-RADS诊断甲状腺良、恶性结节的价值

Value of TI-RADS in diagnosing benign and malignant thyroid nodules

目的探讨甲状腺影像报告和数据系统(TI-RADS)诊断甲状腺良、恶性结节的价值。方法回顾性分析经术后病理证实甲状腺结节患者417例(573个结节)的临床资料。其中,恶性结节组患者246例(299个结节),良性结节组患者171例(274个结节)。根据TI-RADS系统将结节进行危险因素分层绘制TI-RADS的ROC曲线,测定AUC,计算诊断灵敏度、特异度、阳性预测值和阴性预测值。结果甲状腺结节TI-RADS 2、3、4、5级的恶性率分别为0、13.39%(17/127)、67.14%(47/70)、89.35%(235/263),组间差异有统计学意义(P<0.01)。ROC曲线分析显示,TI-RADS诊断良、恶性结节的最佳诊断界点为3级,诊断甲状腺良、恶性结节的灵敏度为95.99%,特异度为81.02%,阳性预测值为84.70%,阴性预测值为94.90%。结论 TI-RADS危险因素分层系统用于诊断甲状腺良、恶性结节具有较高的应用价值。

Objective To explore the diagnostic value of thyroid imaging reporting and data system（TI-RADS）in differentiating benign and malignant thyroid nodules.Methods Data of 417patients（573nodules）with thyroid nodules were retrospectively analyzed,of whom 246cases（299nodules）were with malignant nodules and 171cases（274nodules）were with benign nodules.Using TI-RADS,the risk factors for thyroid nodules were stratified.The ROC curves of TI-RADS in diagnosing benign and malignant thyroid nodules were drawn and AUC and the sensitivity,specificity,positive predictive value and negative predictive value were calculated.Results The malignancy rates of thyroid nodules categorized as TI-RADS category 2,3,4and 5were 0,13.39%（17/127）,67.14%（47/70）and 89.35%（235/263）（P〈0.01）.ROC curve analysis showed that TI-RADS could diagnose benign and malignant nodules with the best diagnostic boundary of grade 3.The sensitivity,specificity,positive predictive value and negative predictive value of TI-RADS in diagnosing benign and malignant thyroid nodules were 95.99%,81.02%,84.70% and 94.90%,respectively.Conclusion The stratification analysis of the risk factors in diagnosing benign and malignant thyroid nodules by TI-RADS has a higher value of application.