摘要
目的观察滤泡性甲状腺影像报告和数据系统(F-TIRADS)鉴别甲状腺良、恶性滤泡性病变的价值。方法回顾性分析502例甲状腺滤泡性病变,包括104例单发恶性结节[恶性组,含77枚甲状腺滤泡癌(FTC)及27枚甲状腺乳头状癌滤泡亚型(FVPTC)]及398例共416枚良性结节[良性组,含197枚甲状腺滤泡腺瘤(FTA)及219枚甲状腺瘤样增生结节];由低年资与高年资医师各1名记录结节超声特征并进行F-TIRADS评分。以病理学结果为金标准,绘制受试者工作特征曲线,计算曲线下面积(AUC),评估F-TIRADS鉴别甲状腺良、恶性滤泡性病变的效能。结果组间病变成分、内部回声、边界、钙化及小梁样结构差异均有统计学意义(P均<0.001)。以≥7为最佳截断值,低年资医师根据F-TIRADS评分鉴别甲状腺良、恶性滤泡性病变的敏感度、特异度、准确率、阳性预测值、阴性预测值分别为76.92%、77.40%、77.31%、93.06%及45.98%,而高年资医师分别为78.84%、81.25%、80.76%、93.89%及51.25%,后者效能高于前者(AUC分别为0.827及0.859,P<0.05)。结论根据F-TIRADS可有效鉴别甲状腺良、恶性滤泡性病变。
Objective To observe the value of follicular thyroid imaging reporting and data system(F-TIRADS)for differentiating benign and malignant follicular thyroid lesions.Methods Totally 502 patients with follicular thyroid lesions were retrospectively enrolled,including 104 patients with single malignant lesion(malignant group,containing 77 follicular thyroid carcinomas[FTC]and 27 follicular variant of papillary thyroid carcinomas[FVPTC])and 398 patients with 416 benign lesions(benign group,containing 197 follicular thyroid adenomas[FTA]and 219 thyroid adenomatous hyperplasia).Ultrasonic features of lesions were recorded,and F-TIRADS scores were assigned by 1 junior and 1 senior ultrasound physicians.Taken histopathology results as gold standard,receiver operating characteristic curve was drawn,the area under the curve(AUC)was calculated to evaluate the efficacy for differentiating benign and malignant follicular thyroid lesions using F-TIRADS.Results Significant differences of composition,internal echo,boundary,calcification and trabecular structure of lesions were found between groups(all P<0.001).Taken F-TIRADS score≥7 as the optimal cut-off value,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value for differentiating benign and malignant follicular thyroid lesions by the junior physician was 76.92%,77.40%,77.31%,93.06%and 45.98%,while by the senior physician was 78.84%,81.25%,80.76%,93.89%and 51.25%,respectively.The efficacy of the latter was higher than of the former(AUC was 0.827 and 0.859,respectively,P<0.05).Conclusion F-TIRADS could effectively identifying benign and malignant follicular thyroid lesions.
作者
李昱臣
肖丽珊
闫萌萌
杜梅霞
赵诚
宁春平
LI Yuchen;XIAO Lishan;YAN Mengmeng;DU Meixia;ZHAO Cheng;NING Chunping(Department of Abdominal Ultrasound,Affiliated Hospital of Qingdao University,Qingdao 266000,China)
出处
《中国医学影像技术》
北大核心
2025年第2期250-253,共4页
Chinese Journal of Medical Imaging Technology
基金
山东省自然科学基金(ZR2020MH290)。
