摘要
目的评估美国放射学会(ACR)2017版TI-RADS(2017-ACR-TI-RADS)诊断老年甲状腺癌的价值。方法回顾性分析2018年1月-2018年12月在复旦大学附属华东医院行超声检查出480个结节(良性306个和恶性174个)的超声特征,根据2017-ACR-TI-RADS的标准将甲状腺结节分为1-5类(TR1-5),绘制受试者工作特征(ROC)曲线及计算曲线下面积(AUC),并比较TR3和TR4分别作为临界值诊断甲状腺癌的效能。结果 2017-ACR-TI-RADS分类预测甲状腺癌的AUC为0.731,以TR3为临界值诊断恶性结节的敏感性和阴性预测值(97.70%和93.85%)明显高于TR4(63.79%和78.86%)(P<0.001),而以TR4为临界值的特异性,准确性和阳性预测值均明显高于TR3(76.80%、72.08%、61.00%vs. 19.93%、48.12%、40.96%)(P<0.001)。结论 2017-ACR-TI-RADS分类系统对老年甲状腺结节患者有一定的诊断价值,但总的诊断效能不够理想,有待进一步研究更加适用于老年患者的TI-RADS。
Objective To explore the diagnostic value of Thyroid Imaging Reporting and Data System of American College of Radiology 2017 edition(2017-ACR-TI-RADS) in thyroid cancer in the elderly patients. Methods The ultrasound characteristics of 480(306 benign and 174 malignant) nodules were analyzed respectively. According to the 2017-ACR-TI-RADS standard, all thyroid nodules were divided into 1-5 categories(TR1-5). The receiver operating characteristic(ROC) curve was plotted and the area under the curve(AUC) was calculated, and the efficacy of TR3 and TR4 as cut-off values for the diagnosis of thyroid cancer was compared. Results According to the ROC, the AUC of 2017-ACR-TI-RADS for predicting malignant nodule was 0.731. The sensitivity and negative predictive value of TR3(97.70% and 93.85%) were higher than those of TR4(63.79% and 78.86%)(P<0.001);however, the specificity, accuracy and positive predictive value of TR4 were significantly higher than those of TR3(76.80%、72.08%、61.00% vs. 19.93%、48.12%、40.96%)(P<0.001). Conclusion2017 ACR TI-RADS have diagnostic value for elderly patients with thyroid nodules, but its total efficiency is not very ideal.Further research is needed to be more suitable for elderly patients with TI-RADS.
作者
史宜鑫
陈林
陈悦
詹嘉
刁雪红
方靓
刘迎春
Shi Yixin;Chen Lin;Chen Yue;Zhan Jia;Diao Xuehong;Fang Liang;Liu Yingchun(Department of Ultrasound,Huadong Hospital Affiliated to Hehai University,Shanghai,200040)
出处
《老年医学与保健》
CAS
2020年第2期299-302,共4页
Geriatrics & Health Care
