Mao S, Zhao L P, Li X H, Sun Y F, Su H, Zhang Y, Li K L, Fan D C, Zhang M Y, Sun Z G, Wang S C
Department of Ultrasound, the Affiliated Hospital of Jining Medical University, Shandong, Jining 272000, China.
Department of Radiology, the Affiliated Hospital of Jining Medical University, Shandong, Jining 272000, China.
Zhonghua Yi Xue Za Zhi. 2021 Dec 7;101(45):3748-3753. doi: 10.3760/cma.j.cn112137-20210401-00799.
To evaluate the diagnostic performance of the Chinese Ultrasound Thyroid Imaging Reporting and Data System (C-TIRADS) in thyroid nodules,and to compare it with the TIRADS proposed by Kwak et al. (K-TIRADS) and the TIRADS proposed by the American College of Radiology (ACR-TIRADS). The data of 1 750 patients with 2 029 thyroid nodules in the Department of Thyroid Surgery, the Affiliated Hospital of Jining Medical University from January 2018 to November 2020 was retrospectively collected. Among them, there were 328 males and 1 422 females,aged from 6 to 86 with an average of (47±12) years. The nodules were divided into≤1.0 cm group(=997) and>1.0 cm group(=1 032)based on the size of the nodules. The stratification for malignant risk and the determination of benign or malignancy of the nodules was evaluated using the C-TIRADS, K-TIRADS and ACR-TIRADS, respectively. The receiver operating characteristic (ROC)curve analysis was performed to compare the diagnostic performance of the aforementioned three kinds of TIRADS using pathological results as the referent standard. The optimal diagnosis points in the determination of malignant nodules of C-TIRADS, K-TIRADS and ACR-TIRADS in the two groups were 4A, 4b and 4 respectively according to ROC curve analysis. For the diagnosis of the malignant nodules, the C-TIRADS achieved with an AUC value of 0.772 and 0.892 in the ≤1.0 cm group and>1.0 cm group, respectively, which was significantly higher than K-TIRADS (AUC= 0.762 and 0.869, respectively) and ACR-TIRADS (AUC= 0.735 and 0.832, respectively) (<0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of C-TIRADS were 94.99%, 59.41%, 86.46%, 88.13%, 78.89% (≤1.0 cm group)and 88.34%, 90.05%, 89.34%, 86.33%, 91.57%(>1.0 cm group), respectively. C-TIRADS had the highest sensitivity, accuracy, and negative predictive value in the determination of malignant nodules in both groups compared to the other two kinds of TIRADS. The three kinds of TIRADS all have high diagnostic performance for the determination of the malignant nodules, and the C-TIRADS has the best overall efficacy, which can effectively assist clinicians for medical decision, and is worth to be popularized and applied in the clinical setting.
评估中国甲状腺超声影像报告和数据系统(C-TIRADS)对甲状腺结节的诊断性能,并将其与Kwak等人提出的TIRADS(K-TIRADS)以及美国放射学会提出的TIRADS(ACR-TIRADS)进行比较。回顾性收集了2018年1月至2020年11月济宁医学院附属医院甲状腺外科1750例患者的2029个甲状腺结节的数据。其中,男性328例,女性1422例,年龄6至86岁,平均(47±12)岁。根据结节大小将结节分为≤1.0 cm组(n = 997)和>1.0 cm组(n = 1032)。分别使用C-TIRADS、K-TIRADS和ACR-TIRADS对结节的恶性风险进行分层以及良恶性判定。以病理结果为参照标准,进行受试者操作特征(ROC)曲线分析,比较上述三种TIRADS的诊断性能。根据ROC曲线分析,C-TIRADS、K-TIRADS和ACR-TIRADS在两组中判定恶性结节的最佳诊断点分别为4A、4b和4。对于恶性结节的诊断,C-TIRADS在≤1.0 cm组和>1.0 cm组的AUC值分别为0.772和0.892,显著高于K-TIRADS(AUC分别为0.762和0.869)和ACR-TIRADS(AUC分别为0.735和0.832)(P<0.05)。C-TIRADS在≤1.0 cm组的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为94.99%、59.41%、86.46%、88.13%、78.89%,在>1.0 cm组分别为88.34%、90.05%、89.34%、86.33%、91.57%。与其他两种TIRADS相比,C-TIRADS在两组恶性结节判定中具有最高的灵敏度、准确度和阴性预测值。三种TIRADS对恶性结节的判定均具有较高的诊断性能,且C-TIRADS总体效能最佳,能够有效协助临床医生进行医疗决策,值得在临床推广应用。