【摘要】 目的:探讨良恶性甲状腺微小结节甲状腺影像报告和数据系统(TI-RADS)、超声引导下细针穿刺细胞学检查(US-FNAC)与术后病理结果的一致性。方法回顾性分析我院60例甲状腺微小结节患者的临床资料,所有患者均接受TI-RADS、US-FNAC,以术后病理结果为"金标准",分析TI-RADS、USFNAC诊断结果与术后病理结果的一致性,计算TI-RADS、US-FNAC诊断良恶性甲状腺微小结节的准确度、特异度、敏感度、阴性预测性、阳性预测值。结果术后病理结果显示,良性甲状腺微小结节38例,恶性甲状腺微小结节22例;TI-RADS诊断结果显示,良性甲状腺微小结节36例,恶性甲状腺微小结节24例,与术后病理结果一致性分析,Kappa值=0.859,提示两者具有良好的一致性;US-FNAC诊断结果显示,良性甲状腺微小结节36例,恶性甲状腺微小结节24例,与术后病理结果一致性分析,Kappa值=0.789,提示两者具有良好的一致性。TI-RADS对甲状腺微小结节的诊断敏感度、特异度、准确度、阳性预测值、阴性预测值分别为92.11%、95.45%、93.33%、97.22%、87.50%。US-FNAC对甲状腺微小结节的诊断敏感度、特异度、准确度、阳性预测值、阴性预测值分别为89.47%、90.91%、90.00%、94.44%、83.33%。结论甲状腺微小结节患者使用TI-RADS和US-FNAC的诊断结果与术后病理结果差异不明显,且两种诊断方式一致性均较高,但TI-RADS诊断优势明显,患者可根据实际情况进行合理选择。更多还原

【Abstract】 Objective:To investigate the consistency of the thyroid imaging report and data system(TIRADS)and ultrasound-guided fine needle aspiration cytology(US-FNAC)with postoperative pathological findings in determining benign and malignant thyroid micronodules.Methods:The clinical data of 60 patients with thyroid micronodules in our hospital were retrospectively analyzed.All patients underwent studies with TI-RADS and US-FNAC.Using postoperative pathology as the gold standard,the diagnostic consistency between TI-RADS,US-FNAC and postoperative pathology was analyzed.The accuracy,specificity,sensitivity,negative predictive value,and positive predictive value of TI-RADS and US-FNAC for diagnosis of benign and malignant thyroid micronodules were calculated.Results:Postoperative pathology identified 38 cases of benign and 22 of malignant thyroid micronodules.TI-RADS identified 36 cases of benign and 24 of malignant thyroid micronodules,showing good consistency with the postoperative pathology by consistency analysis(Kappa= 0.859);US-FNAC identified36 cases of benign and 24 of malignant thyroid micronodules,showing good consistency with the postoperative pathology by consistency analysis(Kappa = 0. 789). The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of TI-RADS for diagnosing thyroid micronodules were 92.11%,95.45%,93.33%,97.22%,and 87.50%,respectively.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of US-FNAC for diagnosing thyroid micronodules were 89.47%,90.91%,90.00%,94.44%,and 83.33%,respectively.Conclusion:The diagnostic performance of either TI-RADS or US-FNAC does not differ significantly with postoperative pathology in patients with thyroid micronodules.While a high consistency exists between the two diagnostic modalities,TI-RADS offers obvious advantages for the diagnosis.Therefore,selection between TI-RADS and US-FNAC can properly be at the discretion of patients based on actual conditions.更多还原