ACR TI-RADS与Kwak TI-RADS结合超声造影对甲状腺结节的诊断价值

Diagnostic value of American College of Radiology and Kwak thyroid imaging reporting anddata system(TI-RADS) combined with contrast-enhanced ultrasound on thyroid nodules

目的:结合超声造影比较美国放射学会发布的ACR TI-RADS与Kwak等制定的TI-RADS在甲状腺结节诊断中的临床应用价值。方法:回顾性分析111例甲状腺结节患者(共计165个结节)的术前超声及造影图像资料,分别用ACR TIRADS和Kwak TI-RADS对结节分类,超声造影后再次Kwak TI-RADS分类,以手术获得的病理资料为"金标准",做ROC曲线,比较分析ACR TI-RADS与Kwak TI-RADS及超声造影后对甲状腺结节的诊断效能。结果:Kwak TI-RADS诊断甲状腺结节良恶性的敏感度、特异度、准确度及曲线下面积(AUC)分别为78.45%、97.96%、84.24%、0.924,ACR TI-RADS诊断甲状腺结节良恶性的敏感度、特异度、准确度及AUC分别为81.90%、83.67%、82.42%、0.878,两者特异度及AUC的差别有统计学意义;超声造影后Kwak TI-RADS诊断甲状腺结节良恶性的敏感度、特异度、准确度及AUC分别为87.07%、81.63%、85.45%、0.926,各指标与Kwak TI-RADS的差别无统计学意义。超声造影后Kwak TI-RADS诊断的敏感度、准确度及AUC均有提高,但不具有统计学意义。结论:Kwak TI-RADS与ACR TI-RADS对甲状腺结节良恶性的鉴别都有较高的诊断价值,且Kwak TI-RADS比ACR TI-RADS有更高的特异度,能更好地诊断良性结节。

Objective: To compare the diagnostic value of thyroid imaging reporting and data system made by American College of Radiology(ACR TI-RADS), Kwak TI-RADS combined with contrast-enhanced ultrasound(CEUS) on thyroid nodules.Methods: Preoperative conventional ultrasound images and contrast-enhanced ultrasound images of 111 patients with thyroid nodules(in total of 165 nodules) were retrospectively analyzed. The nodules were classified with ACR TI-RADS, Kwak TI-RADS and TI-RADS after CEUS, and receiver operating characteristic curve were constructed with surgical pathological results as "golden standard". Diagnostic value of three methods on thyroid nodules was analyzed and diagnostic efficiency was compared. Results: The sensitivity, specificity, accuracy and AUC of Kwak TI-RADS in diagnosing benign and malignant thyroid nodules respectively were 78.45%, 97.96%, 84.24%, 0.924. The sensitivity, specificity, accuracy and AUC of ACR TI-RADS in diagnosing benign and malignant thyroid nodules respectively were 81.90%, 83.67%, 82.42%, 0.878. The difference of specificity and AUC was statistically significant. The sensitivity, specificity, accuracy and AUC of Kwak TI-RADS after CEUS in diagnosing benign and malignant thyroid nodules were respectively 87.07%, 81.63%, 85.45% and 0.926, and the difference between each indicator compared with Kwak TI-RADS was not statistically significant. Conclusion: ACR TI-RADS and Kwak TI-RADS both have high diagnostic value for thyroid nodules, and Kwak TI-RADS has better specificity, especially for the benign nodules.