两种甲状腺超声数据报告系统诊断效能的比较

目的 比较Kwak与ACR(2017)两种甲状腺影像报告和数据系统(TI-RADS)的诊断效能。 方法 回顾性收集2017年3月至2019年4月于山东大学第二医院行手术治疗的792例甲状腺结节患者资料,以1 940个甲状腺结节为研究对象开展研究。由2名从事甲状腺超声专业的高年资医师,分别采用两种TI-RADS评估标准对结节进行回顾性判读并进行统计学评价和比较。 结果 Kwak TI-RADS最佳诊断分界点为≥4a 级,其灵敏度、特异度分别为82.71%、76.06%;ACR(2017)TI-RADS最佳诊断分界点为TR5级,其灵敏度、特异度分别为68.67%、85.46%。Kwak TI-RADS的灵敏度高于ACR(2017)TI-RADS(P<0.001),而ACR(2017)TI-RADS的特异度高于Kwak TI-RADS(P<0.001)。Kwak TI-RADS的受试者工作曲线下面积(AUC)为0.826,高于ACR(2017)TI-RADS的0.810(P=0.024)。在≥1 cm结节中,两种TI-RADS体系的AUC差异无统计学意义(P=0.918);在<1 cm结节中,两种TI-RADS体系的AUC均较低,且Kwak高于ACR(2017)(P<0.001)。 结论 Kwak TI-RADS诊断效能略优于ACR(2017)TI-RADS,Kwak TI-RADS的灵敏度较高,而ACR(2017)TI-RADS的特异度较高。

Comparison of diagnostic efficacy of two kinds of thyroid imagine reporting and data systems

Objective To compare the diagnostic efficacy of Kwak and ACR(2017)thyroid imaging reporting and data system(TI-RADS). Methods Data of 792 patients with thyroid nodules who underwent surgery during March 2017 and April 2019 were retrospectively collected and 1 940 thyroid nodules were enrolled. Imaging features of thyroid nodules were analyzed by two senior qualified sonographers using Kwak and ACR(2017)TI-RADS. Results The best diagnostic cut-off point of Kwak TI-RADS was ≥4a, and the sensitivity and specificity was 82.71% and 76.06%, respectively. The best diagnostic cut-off point of ACR(2017)TI-RADS was TR5, and the sensitivity and specificity was 68.67% and 85.46%, respectively. The sensitivity of Kwak TI-RADS was higher than that of ACR(2017)TI-RADS(P<0.001)while the specificity of ACR(2017)TI-RADS was higher than that of Kwak TI-RADS(P<0.001). The area under the receiver operating characteristic curve(AUC)of Kwak TI-RADS was 0.826, which was higher than that of ACR(2017)TI-RADS(0.810, P=0.024). Both Kwak and ACR(2017)TI-RADS yielded relatively higher overall diagnostic efficacy in nodules ≥1 cm than in nodules <1 cm(P=0.918). In nodules <1cm, Kwak TI-RADS did better than ACR(2017)TI-RADS(P<0.001). Conclusion The overall diagnostic efficacy of Kwak TI-RADS is slightly higher than that of ACR(2017)TI-RADS. Kwak TI-RADS has better performance in sensitivity while ACR(2017)TI-RADS does better in specificity.