不同分类方法在甲状腺结节风险评估中的比较研究.docVIP

不同分类方法在甲状腺结节风险评估中的比较研究 曾红春 周元 刘玉琦 陈辉 张美华 上海市松江区中心医院超声科 X 关注成功！ 加关注后您将方便地在 我的关注中得到本文献的被引频次变化的通知！ 新浪微博 腾讯微博 人人网 开心网 豆瓣网 网易微博 摘????要： 目的 比较2015年美国甲状腺学会 (ATA) 《成人甲状腺结节与分化型甲状腺癌诊治指南》 (简称《2015版指南》) 与Kwak等制定的甲状腺影像报告和数据系统 (TI-RADS) 在甲状腺结节风险评估中的价值。方法 回顾性分析156例患者的甲状腺结节资料, 用两种分类标准对甲状腺结节进行风险评估, 构建受试者工作特征曲线 (ROC曲线) , 比较两种分类方法的诊断效能。结果 Kwak分类的特异度、漏诊率、准确率均高于《2015版指南》 (P0.05) , 《2015版指南》的灵敏度、误诊率高于Kwak分类 (P0.05) 。二者曲线下面积比较无统计学意义。Kwak分类的最佳诊断界值为4b类;《2015版指南》分类的最佳诊断界值为4.5分。联合实验后灵敏度达99.67%、特异度达99.70%。结论 Kwak分类特异度和准确率高于《2015版指南》, 《2015版指南》的灵敏度高于Kwak分类, 两者联合可以明显提高诊断的灵敏度和特异度。 关键词： 甲状腺结节; 超声检查; 诊断; 收稿日期：2017-06-19 Comparative Study on Risk Assessment of Thyroid Nodules with Different Classification Methods Zeng Hongchun Zhou Yuan Liu Yuqi Chen Hui Zhang Meihua Department of Ultrasound, Center Hospital of Songjiang District of Shanghai; Abstract： Objective To compare the value of thyroid imaging reporting and data system (TI-RADS) suggested by Kwak to the ultrasound part of“2015 American Thyroid Association Management Guidelines for Adult patients with Thyroid Nodules and Differentiated Thyroid Cancer”in the assessment of thyroid nodules.Methods The retrospective study included156 patients.All nodules were categorized according to the TI-RADS suggested by Kwak and 2015 version guidelines respectively.The receiver operating characteristic curve (ROC curve) was constructed, and both of the diagnostic value was compared.Results The specificity, missed diagnosis rate, accuracy for TI-RADS suggested by Kwak were higher than those of the 2015 version guidelines (all P 0.05) , and higher sensitivity and misdiagnosis rate in 2015 version guidelines (all P0.05) .There was no significant difference in the area under curve in both.The best diagnostic cut-off value of TI-RADS suggested by Kwak was 4 b, and 4.5 for 2015 version guidelines.After the combined experiment, the sensitivity was 99.67%and the specificity was 99.70%.Conclusions The specificity and accuracy of TI-RADS suggested by K