ACR与结合弹性成像TI-RADS诊断及管理的对比

目的ACR TI-RADS与结合弹性成像TI-RADS分类对于甲状腺结节良恶性诊断的价值及临床管理方法的对比。方法回顾性分析结节313例。根据ACR TI-RADS与结合弹性成像的TI-RADS对其进行分类,以病理为金标准。结果本研究TI-RADS AUC高于ACR TI-RADS(0.842/0.792),P>0.05,灵敏度(77.25%/78.06%),P=0.071>0.05,特异度(94.31%/80.38%),P=0.000<0.05。建议FNA结节(210例/130例)恶性率(59.5%/50.8%)。恶性结节建议FNA,本研究更具优势(125例/66例),占比(80.6%/42.5%),P=0.000。仅4例恶性结节进入无需处理组(4例/30例),占比(0.03%/19.4%),P=0.000。结论本中心结合弹性成像的TI-RADS相对于ACR TI-RADS诊断效能更高。ACR TI-RADS建议进入有创环节患者数量较本研究分类少。本研究分类在筛选恶性结节建议FNA及避免恶性结节建议无需处理方面更具优势。

Comparison of American College of Radiology and Combine with Elastography Thyroid Imaging-Reporting And Data System in Diagnosis and Management

Objective To compare ACR TI-RADS and combine with elastography TI-RADS in diagnosis of benign and malignant and management of thyroid nodules.Methods This study performed retrospective analysis 313 nodules.We categorised the nodules according to ACR TI-RADS and TI-RADS respectively.Pathology was the gold standard.Results The AUC of TI-RADS was higher than ACR TI-RADS(0.842/0.792),P>0.05,sensitivity(77.25%/78.06%),P=0.071>0.05.specificity(94.31%/80.38%),P=0.000<0.05.The nodules which were recommended FNA(210 cases/130 cases)had malignant proportion(59.5%/50.8%).This study had more advantages in recommending malignant nodules FNA(125 cases/66 cases),ratio(80.6%/42.5%),P=0.000.Only 4 cases were recommended no cliniacal treatment(4 cases/30 cases),ratio(0.03%/19.4%),P=0.000.Conclusions This study shows that the diagnostic value TI-RADS is higher than ACR TI-RADS.While ACR TI-RADS suggests less invasive procedures.TI-RADS has more advantages in recommending malignant nodules FNA and avoiding malignant nodules being recommended no cliniacal treatment.