Słowińska-Klencka Dorota, Popowicz Bożena, Klencki Mariusz
Department of Morphometry of Endocrine Glands, Medical University of Lodz, Pomorska Street 251, 92-213 Lodz, Poland.
J Clin Med. 2023 Sep 6;12(18):5809. doi: 10.3390/jcm12185809.
The studies on the effectiveness of various TIRADS in the diagnostics of thyroid nodules differ in the method of ultrasound image assessment: real time (rtUS) vs. static ultrasonography (stUS). The aim of the study was to evaluate the impact of those two methods on the categorization of nodules in EU-TIRADS. Three experienced raters assessed 842 nodules in routine rtUS and reassessed with the use of sUS. Reproducibility of the assessment of malignancy risk features and categorization of nodules with EU-TIRADS was estimated with Krippendorff's alpha coefficient (Kα). The reproducibility of EU-TIRADS categories on sUS in relation to rtUS was in range 70.9-76.5% for all raters (Kα: 0.60-0.68) with the highest reproducibility for category 3 (80.0-86.5%) and the lowest for category 5 (48.7-77.8%). There was a total disagreement of the identification of microcalcifications on sUS in relation to rtUS, a strongly variable reproducibility of marked hypoechogenicity (12.5-84.6%, Kα: 0.14-0.48) and a tendency toward more frequent identification of the non-oval shape on sUS. The percentage of agreement for each pair of raters in assigning the EU-TIRADS category on sUS was in the range 71.6-72.3% (Kα: 0.60-0.62). The method of sonographic image evaluation influences the nodule's feature assessment and, eventually, the categorization within EU-TIRADS.
关于各种甲状腺影像报告和数据系统（TIRADS）在甲状腺结节诊断中有效性的研究，在超声图像评估方法上存在差异：实时（rtUS）与静态超声检查（stUS）。本研究的目的是评估这两种方法对欧洲甲状腺影像报告和数据系统（EU-TIRADS）中结节分类的影响。三名经验丰富的评估者在常规rtUS下评估了842个结节，并使用sUS进行重新评估。使用Krippendorff's alpha系数（Kα）估计EU-TIRADS对恶性风险特征评估和结节分类的可重复性。对于所有评估者，sUS相对于rtUS的EU-TIRADS分类的可重复性在70.9 - 76.5%范围内（Kα：0.60 - 0.68），其中3类的可重复性最高（80.0 - 86.5%），5类最低（48.7 - 77.8%）。与rtUS相比，sUS对微钙化的识别存在完全分歧，显著低回声的可重复性差异很大（12.5 - 84.6%，Kα：0.14 - 0.48），并且sUS上非椭圆形形状的识别倾向更频繁。在sUS上分配EU-TIRADS分类时，每对评估者之间的一致率在71.6 - 72.3%范围内（Kα：0.60 - 0.62）。超声图像评估方法会影响结节特征评估，并最终影响EU-TIRADS内的分类。
