Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea ; Department of Radiology, Jeju National University Hospital, Jeju National School of Medicine, Jeju, Korea.
Biostatistics Collaboration Unit, Medical Research Center, Yonsei University College of Medicine, Seoul, Korea.
Ultrasonography. 2014 Jan;33(1):49-57. doi: 10.14366/usg.13016. Epub 2013 Dec 9.
To verify the usefulness of the Thyroid Imaging Reporting and Data System (TI-RADS) for thyroid nodule diagnosis by less experienced physicians.
From March 2012 to May 2012, ultrasonography-guided fine needle aspiration was performed in 204 thyroid nodules in 195 consecutive patients by four less experienced radiologists (<1 year in thyroid imaging). The number of suspicious ultrasonography features and the total risk score of each thyroid nodule were calculated according to the previous two models suggested by Kwak et al. The Delong method was used to compare the areas under the curve (AUCs) of the two models. Associations between the two models and the risk of malignancy were analyzed using penalized B-splines and the Cochran-Armitage trend test.
Among 204 thyroid nodules, 65 were malignant and 139 were benign. The probability of malignancy tended to increase as the number of suspicious ultrasonography features, and the sum of risk scores increased. There was no significant difference in the AUCs of the two models (P=0.673). The Cochran-Armitage trend test demonstrated an increased risk of malignancy as the number of suspicious ultrasonography features and the total risk score increased (P=0.001).
Both the number of suspicious ultrasonography features and the total risk score are applicable and show comparable results in the risk stratification of thyroid nodules by less experienced radiologists in thyroid imaging.
验证甲状腺影像报告和数据系统(TI-RADS)对于经验不足的医师进行甲状腺结节诊断的有效性。
2012 年 3 月至 2012 年 5 月,4 名经验不足的放射科医师(甲状腺成像时间不足 1 年)对 195 例连续患者的 204 个甲状腺结节进行了超声引导下细针穿刺。根据 Kwak 等人提出的前两种模型,计算每个甲状腺结节的可疑超声特征数量和总风险评分。采用 DeLong 法比较两种模型的曲线下面积(AUC)。采用惩罚 B 样条和 Cochran-Armitage 趋势检验分析两种模型与恶性风险的关系。
在 204 个甲状腺结节中,65 个为恶性,139 个为良性。随着可疑超声特征数量和风险评分总和的增加,恶性概率有增加的趋势。两种模型的 AUC 无显著差异(P=0.673)。Cochran-Armitage 趋势检验表明,随着可疑超声特征数量和总风险评分的增加,恶性风险增加(P=0.001)。
对于甲状腺成像经验不足的放射科医师,可疑超声特征数量和总风险评分均适用于甲状腺结节的风险分层,且结果相当。