目的:比较中国甲状腺影像报告和数据系统(C-TIRADS)与公认的ACR-TIRADS指南在鉴别良性和恶性甲状腺结节方面的诊断效能。
方法:收集了2019年10月至2021年11月在我们中心接受甲状腺超声检查的1627例患者的2064个结节。结节分为两组:“≥1cm”和“<1cm”。由两名具有15年以上经验的医师观察并记录每个结节的超声特征,并根据ACR-TIRADS和C-TIRADS指南进行分类。分别。
结果:ACR-TIRADS指南的曲线下面积高于C-TIRADS指南的曲线下面积(0.922,P=0.017),C-TIRADS指南的特异性和阳性预测值更高(81.64%,88.72%,所有P<0.05),在结节<1cm的亚组中更为显着(P=0.001)。此外,两个指南对结节≥1cm的诊断效能指标无统计学差异.与C-TIRADS相比,ACR-TIRADS有效减少了不必要的活检(P<0.05)。
结论:两个指南对甲状腺结节的诊断有很高的一致性,C-TIRADS指南具有更高的特异性和简单性,而在减少活检数量方面不如ACR-TIRADS指南。
To compare the diagnostic efficacy of the Chinese Thyroid Imaging Reporting and Data Systems (C-TIRADS) with the well-accepted ACR-
TIRADS guidelines in identifying benign from malignant thyroid nodules.
A total of 2064 nodules were collected from 1627 patients undergoing thyroid ultrasonography in our center between October 2019 and November 2021. Nodules were divided into two groups: \"≥1 cm\" and \"<1 cm\". Ultrasound features of each nodule were observed and recorded by two physicians with more than 15 years of experience and classified according to the ACR-TIRADS and C-
TIRADS guidelines, respectively.
The area under the curve of the ACR-
TIRADS guideline was higher than that of the C-
TIRADS guideline (0.922, P = 0.017), the specificity and positive predictive value of the C-
TIRADS guideline were higher (81.64%, 88.72%, all P < 0.05), which was more significant in the subgroup of nodules <1 cm (P = 0.001). In addition, there was no statistical difference between the two guidelines in the diagnostic efficacy indicators for nodules ≥1 cm. The ACR-TIRADS effectively reduced unnecessary biopsies compared with the C-TIRADS (P < 0.05).
There was high agreement between the two guidelines for the diagnosis of thyroid nodules, C-TIRADS
guidelines had a higher specificity and simplicity while were inferior to the ACR-
TIRADS guidelines in terms of reducing the number of biopsies.