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人工智能辅助诊断系统联合超声造影对甲状腺 TI-RADS 4 结节的诊断价值。

Diagnostic Value of Artificial Intelligence-Assistant Diagnostic System Combined With Contrast-Enhanced Ultrasound in Thyroid TI-RADS 4 Nodules.

机构信息

Department of Ultrasound, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.

Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China.

出版信息

J Ultrasound Med. 2023 Jul;42(7):1527-1535. doi: 10.1002/jum.16170. Epub 2023 Feb 1.

Abstract

OBJECTIVES

This study evaluated the diagnostic value of artificial intelligence-assistant diagnostic system combined with contrast-enhanced ultrasound in The American College of Radiology Thyroid Imaging, Reporting and Data System (ACR TI-RADS) 4 category thyroid nodules.

METHODS

Thyroid nodules that were evaluated as ACR TI-RADS 4 by conventional ultrasound were selected, all of which had pathological or fine needle aspiration (FNA) results. All nodules were examined by contrast-enhanced ultrasound (CEUS) and artificial intelligence (AI) analysis. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of AI, CEUS and their combined diagnosis were compared; Analyzed and compared the diagnostic efficiency of AI, CEUS and their combined diagnosis.

RESULTS

A total of 148 thyroid nodules were included in 140 patients, including 58 malignant nodules and 89 benign nodules. The sensitivity of combined diagnosis was significantly higher than that of AI or CEUS alone (P < .05). The NPV of AI, CEUS and combined diagnosis were statistically significant (P < .05). There was no significant difference in the diagnostic efficacy between AI and CEUS (P > .05), but there was a significant difference in NPV between AI and combined diagnosis (P < .05). The AUC of the combined diagnosis was 0.859, which was higher than that of AI, CEUS alone.

CONCLUSIONS

AI has a high diagnostic efficiency, which was helpful for radiologists to make rapid assessment. AI combined CEUS can significantly improve the diagnostic sensitivity and NPV, which was beneficial for the early detection of malignant nodules.

摘要

目的

本研究评估了人工智能辅助诊断系统联合增强超声在符合美国放射学会甲状腺影像报告和数据系统(ACR TI-RADS)4 类甲状腺结节中的诊断价值。

方法

选择经常规超声评估为 ACR TI-RADS 4 类的甲状腺结节,所有结节均有病理或细针穿刺(FNA)结果。所有结节均行超声造影(CEUS)和人工智能(AI)分析检查。比较 AI、CEUS 及其联合诊断的灵敏度、特异度、准确性、阳性预测值(PPV)和阴性预测值(NPV);分析和比较 AI、CEUS 及其联合诊断的诊断效能。

结果

共纳入 140 例患者的 148 个甲状腺结节,包括 58 个恶性结节和 89 个良性结节。联合诊断的灵敏度明显高于 AI 或 CEUS 单独诊断(P<.05)。AI、CEUS 和联合诊断的 NPV 均有统计学意义(P<.05)。AI 和 CEUS 的诊断效能无显著差异(P>.05),但 AI 与联合诊断的 NPV 有显著差异(P<.05)。联合诊断的 AUC 为 0.859,高于 AI 和 CEUS 单独诊断。

结论

AI 具有较高的诊断效能,有助于放射科医生快速评估。AI 联合 CEUS 可显著提高诊断灵敏度和 NPV,有利于恶性结节的早期检出。

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