美国放射学院 TI-RADS、韩国甲状腺放射学会 TIRADS 和美国甲状腺协会指南的性能特征比较。
Comparison of Performance Characteristics of American College of Radiology TI-RADS, Korean Society of Thyroid Radiology TIRADS, and American Thyroid Association Guidelines.
机构信息
1 Mallinckrodt Institute of Radiology, Washington University in St. Louis, 510 S Kingshighway Blvd, St. Louis, MO 63110.
2 Mayo Clinic, Rochester, MN.
出版信息
AJR Am J Roentgenol. 2018 May;210(5):1148-1154. doi: 10.2214/AJR.17.18822. Epub 2018 Apr 9.
OBJECTIVE
The American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) provides guidelines to practitioners who interpret sonographic examinations of thyroid nodules. The purpose of this study is to compare the ACR TI-RADS system with two other well-established guidelines.
MATERIALS AND METHODS
The ACR TI-RADS, the Korean Society of Thyroid Radiology (KSThR) Thyroid Imaging Reporting and Data System (TIRADS), and the American Thyroid Association guidelines were compared using 3422 thyroid nodules for which pathologic findings were available. The composition, echogenicity, margins, echogenic foci, and size of the nodules were assessed to determine whether a recommendation would be made for fine-needle aspiration or follow-up sonography when each system was used. The biopsy yield of malignant findings, the yield of follow-up, and the percentage of malignant and benign nodules that would be biopsied were determined for all nodules and for nodules 1 cm or larger.
RESULTS
The percentage of nodules that could not be classified was 0%, 3.9%, and 13.9% for the ACR TI-RADS, KSThR TIRADS, and ATA guidelines, respectively. The biopsy yield of malignancy was 14.2%, 10.2%, and 10.0% for nodules assessed by the ACR TI-RADS, KSThR TIRADS, and ATA guidelines, respectively. The percentage of malignant nodules that were biopsied was 68.2%, 78.7%, and 75.9% for the ACR TI-RADS, the KSThR TIRADS, and the ATA guidelines, respectively, whereas the percentage of malignant nodules that would be either biopsied or followed was 89.2% for the ACR TI-RADS. The percentage of benign nodules that would be biopsied was 47.1%, 79.7%, and 78.1% for the ACR TI-RADS, the KSThR TIRADS, and the ATA guidelines, respectively. The percentage of benign nodules that would be either biopsied or followed was 65.2% for the ACR TI-RADS.
CONCLUSION
The ACR TI-RADS performs well when compared with other well-established guidelines.
目的
美国放射学院（ACR）甲状腺影像报告和数据系统（TI-RADS）为解读甲状腺结节超声检查的医生提供了指南。本研究的目的是比较 ACR TI-RADS 系统与另外两个成熟的指南。
材料和方法
使用 3422 个有病理结果的甲状腺结节，比较 ACR TI-RADS、韩国甲状腺放射学会（KSThR）甲状腺影像报告和数据系统（TIRADS）以及美国甲状腺协会指南。评估结节的构成、回声、边界、回声灶和大小，以确定当使用每个系统时是否推荐进行细针抽吸或超声随访。确定所有结节以及 1cm 或更大的结节的恶性发现活检率、随访率以及需要活检的恶性和良性结节的百分比。
结果
ACR TI-RADS、KSThR TIRADS 和 ATA 指南的不可分类结节百分比分别为 0%、3.9%和 13.9%。ACR TI-RADS、KSThR TIRADS 和 ATA 指南评估的结节的恶性发现活检率分别为 14.2%、10.2%和 10.0%。接受 ACR TI-RADS、KSThR TIRADS 和 ATA 指南评估的恶性结节活检率分别为 68.2%、78.7%和 75.9%，需要活检或随访的恶性结节比例分别为 89.2%、78.7%和 75.9%。接受 ACR TI-RADS、KSThR TIRADS 和 ATA 指南评估的良性结节活检率分别为 47.1%、79.7%和 78.1%，需要活检或随访的良性结节比例分别为 65.2%、79.7%和 78.1%。
结论
与其他成熟的指南相比，ACR TI-RADS 表现良好。
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