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[目的]对比探讨甲状腺影像报告和数据系统(thyroid imaging reporting and data system,TI-RADS分类)与常规超声在诊断甲状腺结节良恶性中的诊断效能。[方法]对253例患者共266个甲状腺结节行常规超声检查,观察病灶的大小、数量、形态、边界、内部回声及后场情况特征并评估良恶性,同时运用TI-RADS分类方法对上述结节进行分类,以TI-RADS分类2、3、4a类为良性结节,4b、4c、5类为恶性结节;结果均以病理为参照标准进行分析。[结果 ]常规超声诊断甲状腺结节良恶性:灵敏度70.7%、特异度87.5%、准确率85.0%、阳性预测值50.8%、阴性预测值94.3%;TI-RADS分类诊断甲状腺结节良恶性:灵敏度90.2%、特异度81.3%、准确率82.7%、阳性预测值46.8%、阴性预测值97.9%。TI-RADS分类较常规超声具有较高敏感性(P=0.026)。[结论]TI-RADS分类与常规超声在甲状腺结节定性诊断中均具有较高的诊断价值;TI-RADS分类系统是一个标准化工具,使甲状腺结节超声定性诊断规范化,利于临床对患者分类管理。
[Objective] To investigate the diagnostic efficacy of thyroid imaging reporting and data system (TI-RADS classification) and routine ultrasound in the diagnosis of benign and malignant thyroid nodules. [Methods] A total of 266 thyroid nodules of 253 patients underwent routine ultrasound examination. The size, number, morphology, boundary, internal echo and the characteristics of the back field were observed and the benign and malignant lesions were evaluated. At the same time, Nodules were classified according to TI-RADS classification 2,3,4a class benign nodules, 4b, 4c, 5 categories of malignant nodules; the results were pathological as a reference standard for analysis. [Results] Routine ultrasound diagnosis of benign and malignant thyroid nodules: sensitivity 70.7%, specificity 87.5%, accuracy 85.0%, positive predictive value 50.8%, negative predictive value 94.3%; TI-RADS classification of benign and malignant thyroid nodules: sensitivity 90.2%, specificity 81.3%, accuracy 82.7%, positive predictive value 46.8%, negative predictive value 97.9%. TI-RADS classification is more sensitive than conventional ultrasound (P = 0.026). [Conclusion] TI-RADS classification and routine ultrasound have high diagnostic value in the qualitative diagnosis of thyroid nodules. TI-RADS classification system is a standardized tool to standardize the qualitative diagnosis of thyroid nodules, which is beneficial to clinical classification management of patients .