C-TIRADS、Kwak TIRADS分类系统对甲状腺4类结节诊断效能的比较

Comparison of diagnostic efficacy of C-TIRADS and Kwak TIRADS classification system in 4 types of thyroid nodules

目的 探讨C-TIRADS分类系统和Kwak TIRADS分类系统对甲状腺4类结节的诊断效能。方法 收集2021年1月至2021年12月于孝感市中心医院行甲状腺超声检查的患者,按照随机数字表单复数进行分组,单数组使用C-TIRADS分类系统(C-TIRADS组)、复数组使用2011版Kwak甲状腺影像报告和数据系统(Kwak TIRADS组)评估。最终选取有病理结果的C-TIRADS组患者221例、Kwak TIRADS组患者234例。以病理结果为金标准计算灵敏性和特异性并绘制受试者工作曲线,比较两种分类系统对4类结节的诊断效能。结果 C-TIRADS及Kwak TIRADS分类系统对鉴别甲状腺4类结节良恶性的最佳诊断截断值均为4B。C-TIRADS、Kwak TIRADS的AUC值分别为0.85 (95%CI:0.80~0.90)、0.76 (95%CI:0.70~0.83)。C-TIRADS、Kwak TITADS对4类结节诊断的灵敏度分别为83.60%、95.02%,特异度分别为87.90%、72.10%,阳性预测值分别为89.05%、82.79%,阴性预测值分别为83.80%、72.52%;准确率分别为84.00%、86.80%。结论 C-TIRADS对甲状腺4类结节良恶性的最佳截断值为4B,且较Kwak TITADS分类系统对甲状腺4类结节有更高的诊断效能。

【Objective】To investigate the diagnostic efficacy of C-TIRADS and Kwak TIRADS classification system for 4 types of thyroid nodules. 【Methods】Patients who underwent thyroid ultrasonography in Xiaogan Central Hospital from January 2021 to December 2021 were divided according to the plural number of random numbers form, and the singular group was evaluated using the C-TIRADS classification system(C-TIRADS group), and the complex group was evaluated using the 2011 version of the Kwak thyroid imaging reporting and data system(Kwak TIRADS group). Finally, 221 patients in the C-TIRADS group and 234 patients in the Kwak TIRADS group with pathological results were selected. Using pathological results as the gold standard to calculate the sensitivity and specificity and draw the receiver operating curve to compare the diagnostic efficacy of the two classification systems for nodules in Category 4. 【Results】The best diagnostic cut-off values of C-TIRADS and Kwak TIRADS classification systems for differentiating benign and malignant from 4-category thyroid nodules were 4B. The AUC values of C-TIRADS, Kwak TIRADS were 0.85(95% CI: 0.80-0.90), 0.76(95% CI: 0.70–0.83), respectively. The sensitivity of C-TIRADS,Kwak TIRADS for the diagnosis of category 4 nodules was 83.60%, 95.02%, the specificity was 87.90%, 72.10%, the positive predictive value was 89.05%, 82.79%, and the negative predictive value was 83.80%, 72.52%(P<0.05), the accuracy was 84.00%,86.80%. 【Conclusion】The optimal cut-off value of C-TIRADS for benign and malignant thyroid category 4 nodules is 4B, and it has higher diagnostic efficacy for thyroid category 4 nodules than the Kwak TIRADS.