ACR-TIRADS、EU-TIRADS及KTA/KSThRTIRADS评估甲状腺结节一致性的研究

Interobserver variability in sonographic evaluation of thyroid nodules with ACR-TI-RADS,EU-TIRADS and KTA/KSThR-TIRADS

目的研究3种不同甲状腺影像报告与数据系统(TI-RADS)及不同超声征象观察者间一致性。方法回顾性分析2017年1月至2017年12月民航总医院手术切除的257个甲状腺结节(168例患者),并根据美国放射学会(ACR)TI-RADS、欧洲甲状腺协会(EU)TI-RADS和韩国甲状腺协会(KTA)/韩国甲状腺放射科学会(KSThR)TI-RADS归类。应用加权Kappa检验比较读图者间3种风险分层整体一致性,Kappa检验用于评估读图者间对于3种风险分层分类及不同超声征象的一致性。结果ACR-TIRADS、EU-TIRADS及KTA/KSThR-TIRADS评估Kappa值分别为0.62、0.45、0.64。ACR-TIRADS 5类、EU-TI-RADS高危和KTA/KSThR-TI-RADS高度可疑类评估Kappa值分别为0.726、0.686、0.721。各超声征象描述中囊性、卵圆形、直立生长评估Kappa值分别为0.733、0.700、0.738。结论ACR-TI-RADS与KTA/KSThR-TI-RADS整体评估一致性较好。3种风险分层对于高风险类结节的评估一致性较好,具有较好的临床适用性。

Objective To retrospectively evaluate interobserver variability in sonographic evaluation of thyroid nodules with three different thyroid imaging reporting and data systems(TI-RADS).Methods This retrospective study included 257 thyroid nodules of 168 patients confirmed by pathology at Civil Aviation General Hospital between January to December 2017.All nodules were categorized according to the ACR-TIRADS,EU-TIRADS,and KTA/KSThR-TIRADS.Interobserver variability for the three different TI-RADS was determined using weighted Kappa statistics.Interobserver variability for the classification level of different TI-RADS and ultrasonic characteristics evaluation was also determined.Results The Kappa values for ACR-TI-RADS,EU-TI-RADS,and KTA/KSThR-TI-RADS were 0.62,0.45,and 0.64 respectively.For ACR-TI-RADS 5,EU-TI-RADS high risk,and KTA/KSThR-TI-RADS high suspicion level,the Kappa values were 0.726,0.686,and 0.721,respectively.For US assessment of the cystic,oval shape,and taller-than-wide signs,the Kappa value were 0.733,0.700,and 0.738,respectively.Conclusion Interobserver agreement is good for diagnosing thyroid nodules with ACR-TIRADS and KTA/KSThR-TIRADS.There is good interobserver agreement on high risk level among the three different TIRADS,which providing better clinical practicability.