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时间:2018-12-06
《不同分类方法在甲状腺结节风险评估中的比较研究》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、不同分类方法在甲状腺结节风险评估中的比较研究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(T1-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》(P〈0.05),《2015版指南》的灵敏度、误诊率高于Kwak分类(P〈0.05
2、)。二荠曲线下而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:2017-06-19ComparativeStudyonRiskAssessmentofThyroidNoduleswithDifferentClassificationMethodsZengHongchunZhouYuanLiuYuq
3、iChenHuiZhangMeihuaDepartmentofUltrasound,CenterHosnitalofSongjiangDistrictofShanghai;Abstract:ObjectiveTocomparethevalueofthyroidimagingreportinganddatasystem(TI-RADS)suggestedbyKwaktotheultrasoundpartof“2015AmericanThyroidAssociationManagementGuidelinesforAdultpatientswithThyroidNodulesandDiffer
4、entiatedThyroidCancernintheassessmentofthyroidnodules.MethodsTheretrospectivestudyincludcdl56patients.AllnoduleswerecategorizedaccordingtotheTI-RADSsuggestedbyKwakand2015versionguidelinesrespectively.Thereceiveroperatingcharacteristiccurve(ROCcurve)wasconstructed,andbothofthediagnosticvaluewascomp
5、ared.ResultsThespecificity,misseddiagnosisrate,accuracyforTI-RADSsuggestedbyKwakwerehigherthanthoseofthe2015versionguidelines(allP<0.05),andhighersensitivityandmisdiagnosisratein2015versionguidelines(allP<0.05).Therewasnosignificantdifferenceintheareaundercurveinboth.Thebestdiagnosticcut-offvalueo
6、fTI-RADSsuggestedbyKwakwas4b,and4.5for2015versionguidelines.Afterthecombinedexperiment,thesensitivitywas99-67%andthespecificitywas99.70%.ConclusionsThespecificityandaccuracyofTI-RADSsuggestedbyKwakishigherthanthoseof2015versionguidelines,andhighersensitivityin2015versionguidelines.Thehighersensiti
7、vityandspecificitycouldbeobtainedfromthecombinationofthem.Keyword:Thyroidnodule;Ultrasonography;Diagnosis;Received:2017-06-19KWAK等丄提出的甲状腺数据与影像系统(thyroidimagingreportinganddatasystem,TI-RADS)应用简便,易于被超声及临床医师所接受。由于不
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