Park Chang Suk, Kim Sung Hun, Jung So Lyung, Kang Bong Joo, Kim Jee Young, Choi Jae Jung, Sung Mi Suk, Yim Hyeon Woo, Jeong Seung Hee
Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, 403-720, Korea.
J Clin Ultrasound. 2010 Jul;38(6):287-93. doi: 10.1002/jcu.20689.
Inter- and intraobserver variabilities in the description and diagnostic categorization of sonographic (US) features of thyroid nodules were evaluated.
The current study was conducted on 72 malignant nodules and 61 benign nodules. The US findings for each thyroid nodule were analyzed twice at a 6-week interval by five radiologists. The analyses were in accordance with the guidelines proposed by the Thyroid Study Group of the Korean Society of Neuroradiology and Head and Neck Radiology (TSGKSNRHNR). Inter- and intraobserver variabilities were calculated using Cohen's kappa statistics. The sensitivity, specificity, positive-predictive value, and negative-predictive value in the assessment of the diagnostic accuracy using these guidelines were calculated.
The interobserver agreement was fair to substantial for US features and categorization. Of the US features of the thyroid nodules, internal content (solid versus cystic) showed substantial agreement (k = 0.64). There was moderate agreement with regard to shape, echogenicity, calcification, and diagnostic categories (k = 0.42, 0.57, 0.55, and 0.55, respectively). There was fair agreement for margin, echotexture, and capsule invasion (k = 0.34, 0.26, and 0.32, respectively). With regard to intraobserver agreement, there was moderate to substantial agreement for all US features except for echotexture and capsule invasion, which showed fair agreement. In particular, there was moderate to almost perfect agreement for the diagnostic category. The sensitivity, specificity, positive-predictive value, and negative-predictive value were 65.3%-81.9%, 60.7%-68.9%, 69.7%-73.8%, and 66.6%-75.5%, respectively.
There were high degrees of inter- and intraobserver agreement using the "Guidelines for diagnostic thyroid ultrasonography," of the TSGKSNRHNR in the description and categorization of thyroid nodules.
评估甲状腺结节超声（US）特征描述及诊断分类中的观察者间和观察者内变异性。
本研究纳入72个恶性结节和61个良性结节。由五名放射科医生对每个甲状腺结节的超声检查结果每隔6周进行两次分析。分析遵循韩国神经放射学会和头颈放射学会甲状腺研究组（TSGKSNRHNR）提出的指南。使用Cohen's kappa统计量计算观察者间和观察者内变异性。计算使用这些指南评估诊断准确性时的敏感性、特异性、阳性预测值和阴性预测值。
观察者间在超声特征及分类方面的一致性为一般至高度一致。在甲状腺结节的超声特征中，内部成分（实性与囊性）显示高度一致（κ = 0.64）。在形状、回声性、钙化及诊断分类方面存在中度一致（分别为κ = 0.42、0.57、0.55和0.55）。在边界、回声质地及包膜侵犯方面存在一般一致（分别为κ = 0.34、0.26和0.32）。关于观察者内一致性，除回声质地和包膜侵犯显示一般一致外，所有超声特征均存在中度至高度一致。特别是，诊断分类存在中度至几乎完美的一致。敏感性、特异性、阳性预测值和阴性预测值分别为65.3% - 81.9%、60.7% - 68.9%、69.7% - 73.8%和66.6% - 75.5%。
使用TSGKSNRHNR的“甲状腺超声诊断指南”对甲状腺结节进行描述和分类时，观察者间和观察者内一致性程度较高。
