您的位置:山东大学 -> 科技期刊社 -> 《山东大学学报(医学版)》

山东大学学报 (医学版) ›› 2020, Vol. 58 ›› Issue (7): 53-59.doi: 10.6040/j.issn.1671-7554.0.2019.1505

• • 上一篇    

两种甲状腺超声数据报告系统诊断效能的比较

肖娟1,肖强2,丛伟3,李婷4,丁守銮1,张媛1,邵纯纯1,吴梅4,刘佳宁3,贾红英1   

  1. 1. 山东大学第二医院基础医学研究所/循证医学中心, 山东 济南 250033;2. 山东大学公共卫生学院生物统计系, 山东 济南 250012;3. 山东大学第二医院甲状腺外科, 山东 济南 250033;4. 山东大学第二医院医学影像中心超声科, 山东 济南 250033
  • 发布日期:2020-07-10
  • 通讯作者: 贾红英. E-mail: jiahongying@sdu.edu.cn
  • 基金资助:
    山东大学教育教学改革重点项目(2019Z10)

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

XIAO Juan1, XIAO Qiang2, CONG Wei3, LI Ting4, DING Shouluan1, ZHANG Yuan1, SHAO Chunchun1, WU Mei4, LIU Jianing3, JIA Hongying1   

  1. 1. Center of Evidence-Based Medicine, Institute of Medical Sciences, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, Shandong, China;
    2. Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    3. Department of Thyroid Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, Shandong, China;
    4. Center of Ultrasonography, Department of Medical Imaging, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, Shandong, China
  • Published:2020-07-10

摘要: 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。

关键词: 甲状腺影像报告和数据系统, Kwak TI-RADS, ACR(2017)TI-RADS, 诊断效能

Abstract: 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.

Key words: Thyroid imaging reporting and data system, Kwak TI-RADS, ACR(2017)TI-RADS, Diagnostic efficacy

中图分类号: 

  • R445.1
[1] Horvath E, Majlis S, Rossi R, et al. An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management [J]. J Clin Endocrinol Metab, 2009, 94(5): 1748-1751.
[2] Haugen BR, Alexander EK, Bible KC, et al. 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer [J]. Thyroid, 2016, 26(1): 1-133.
[3] Gharib H, Papini E, Garber JR, et al. American association of clinical endocrinologists, American college of endocrinology, and associazione medici endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules—2016 Update [J]. Endocr Pract, 2016, 22(5): 622-639.
[4] Perros P, Boelaert K, Colley S, et al. Guidelines for the management of thyroid cancer[J]. Clin Endocrinol, 2014, 81,Suppl 1:1-122. doi: 10.1111/cen.12515.
[5] Russ G, Bonnema SJ, Erdogan MF, et al. European thyroid association guidelines for ultrasound malignancy risk stratification of thyroid nodules in adults: the EU-TIRADS [J]. Eur Thyroid J, 2017, 6(5): 225-237.
[6] Kwak JY, Han KH, Yoon JH, et al. Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk [J]. Radiology, 2011, 260(3): 892-899.
[7] 岳林先, 陈琴. 国内甲状腺影像报告和数据系统的运用现状与对策[J]. 现代临床医学, 2018, 44(5): 397-400.
[8] Kwak JY, Jung I, Baek JH, et al. Image reporting and characterization system for ultrasound features of thyroid nodules: multicentric Korean retrospective study [J]. Korean J Radiol, 2013, 14(1): 110-117.
[9] Migda B, Migda M, Migda MS. A systematic review and meta-analysis of the Kwak TIRADS for the diagnostic assessment of indeterminate thyroid nodules [J]. Clin Radiol, 2019, 74(2): 123-130.
[10] Rahman ST, McLeod DSA, Pandeya N, et al. Understanding pathways to the diagnosis of thyroid cancer: are there ways we can reduce over-diagnosis [J]. Thyroid, 2019, 29(3): 341-348.
[11] Tessler FN, Middleton WD, Grant EG, et al. ACR thyroid imaging, reporting and data system(TI-RADS): white paper of the ACR TI-RADS committee [J]. J Am Coll Radiol, 2017, 14(5): 587-595.
[12] Middleton WD, Teefey SA, Reading CC, et al. Comparison of performance characteristics of American college of radiology TI-RADS, Korean society of thyroid radiology TIRADS, and American thyroid association guidelines [J]. AJR Am J Roentgenol, 2018, 210(5): 1148-1154.
[13] Wu XL, Du JR, Wang H, et al. Comparison and preliminary discussion of the reasons for the differences in diagnostic performance and unnecessary FNA biopsies between the ACR TIRADS and 2015 ATA guidelines [J]. Endocrine, 2019, 65(1): 121-131.
[14] Shapira-Zaltsberg G, Miller E, Martinez-Rios C, et al. Comparison of the diagnostic performance of the 2017 ACR TI-RADS guideline to the Kwak guideline in children with thyroid nodules[J]. Pediatr Radiol, 2019,49(7):862-868.
[15] DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach [J]. Biometrics, 1988, 44(3): 837-845.
[16] 梁羽, 岳林先, 陈琴, 等. Kwak与ACR(2017)甲状腺影像报告和数据系统(TI-RADS)分类的诊断效能比较——多中心回顾性研究[J]. 中华超声影像学杂志, 2019, 28(5): 419-424. LIANG Yu, YUE Linxian, CHEN Qin, et al. Efficiency comparison of Kwak and ACR(2017)thyroid imaging reporting and data system(TI-RADS)classification a polycentric retrospective study [J]. Chinese Journal of Ultrasonography, 2019, 28(5): 419-424.
[17] 张于芝, 徐婷, 顾经宇, 等. 美国放射学会甲状腺影像报告和数据系统(ACR-TIRADS)对甲状腺结节鉴别诊断的效能评估[J]. 中华超声影像学杂志, 2018, 27(6): 505-509. ZHANG Yuzhi, XU Ting, GU Jingyu, et al. Effectiveness evaluation of the thyroid imaging report and data system proposed by American radiological society(2017)(ACR-TIRADS)for differential diagnosis in thyroid nodules [J]. Chinese Journal of Ultrasonography, 2018, 27(6): 505-509.
[18] Gao L, Xi X, Jiang Y, et al. Comparison among TIRADS(ACR TI-RADS and KWAK- TI-RADS)and 2015 ATA guidelines in the diagnostic efficiency of thyroid nodules [J]. Endocrine, 2019, 64(1): 90-96.
[19] Grani G, Lamartina L, Ascoli V, et al. Reducing the number of unnecessary thyroid biopsies while improving diagnostic accuracy: toward the “right” TIRADS [J]. J Clin Endocrinol Metab, 2019, 104(1): 95-102.
[20] 李进叶, 宋歌声, 宋吉清, 等. 宝石能谱 CT 与常规超声对甲状腺结节良恶性诊断价值的对照分析[J]. 山东大学学报(医学版), 2016, 54(3): 81-85. LI Jinye, SONG Gesheng, SONG Jiqing, et al. Comparative study of gemstone spectral CT and conventional ultrasound spectroscopy for the diagnosis of benign and malignant thyroid nodules[J]. Journal of Shandong University(Health Sciences), 2016, 54(3): 81-85.
[21] Migda B, Migda M, Migda MS, et al. Use of the Kwak thyroid image reporting and data system(K-TIRADS)in differential diagnosis of thyroid nodules: systematic review and meta-analysis [J]. Eur Radiol, 2018, 28(6): 2380-2388.
[22] Davies L, Welch HG. Current thyroid cancer trends in the United States [J]. JAMA Otolaryngol Hed Neck Surg, 2014, 140(4): 317-322.
[23] Brito JP, Moon JH, Zeuren R, et al. 2018 thyroid cancer treatment choice: a pilot study of a tool to facilitate conversations with patients with papillary microcarcinomas considering treatment options [J]. Thyroid, 2018, 28(10): 1325-1331.
[24] Ye ZQ, Gu DN, Hu HY, et al. Hashimotos thyroiditis, microcalcification and raised thyrotropin levels within normal range are associated with thyroid cancer [J]. World J Surg Oncol, 2013, 11(5): 56.
[25] Dobruch-Sobczak KS, Krauze A, Migda B, et al. Integration of sonoelastography into the TIRADS lexicon could influence the classification [J]. Front Endocrinol(Lausanne), 2019, 10(5): 127.
[26] Ha SM, Chung YJ, Ahn HS, et al. Echogenic foci in thyroid nodules: diagnostic performance with combination of TIRADS and echogenic foci [J]. BMC Med Imaging, 2019, 19(1): 28. doi: 10.1186/s12880-019-0328-2.
No related articles found!
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!