【摘要】 目的 比较住院医师应用C-TIRADS与ACR-TIRADS、EU-TIRADS、K-TIRADS、Kwak-TIRADS对甲状腺结节的诊断效能，评估C-TIRADS对甲状腺结节的诊断价值。方法 应用各版TIRADS回顾性分析472例甲状腺结节，以细胞病理学结果为金标准绘制ROC曲线并计算曲线下面积(AUC),确定最佳截断值，通过Kappa检验比较C-TIRADS与其他多种TIRADS的诊断一致性。结果 C-TIRADS的AUC高于ACR-TIRADS、EU-TIRADS、K-TIRADS、Kwak-TIRADS(0.812 vs. 0.751、0.733、0.733、 0.737,P<0.000 1),具有良好的诊断效能，C-TIRADS>4b、ACR-TIRADS>4、EU-TIRADS>4、K-TIRADS>4、Kwak-TIRADS>4b时，C-TIRADS与ACR-TIRADS(Kappa=0.779)、Kwak-TIRADS(Kappa=0.611)诊断一致性较强，与K-TIRADS(Kappa=0.552)、EU-TIRADS(Kappa=0.545)诊断一致性中等，P<0.000 1。结论 住院医师应用C-TIRADS评估甲状腺结节恶性风险的诊断价值良好，C-TIRADS适用于我国甲状腺结节患者的超声分类评估。更多还原

【Abstract】 Objective To compare the diagnostic performance of 2020 Chinese guidelines for malignant risk stratification of thyroid nodules(C-TIRADS) with the thyroid imaging reporting and systems(TIRADS) proposed by American college of radiology(ACR), european thyroid association(EU), korean thyroid association/korean society of thyroid radiology(K) and Kwak(Kwak) in thyroid nodules, and to evaluate the diagnostic value of C-TIRADS for sonographic malignancy risk stratification of thyroid nodules by residents. Methods A total of 472 cases of thyroid nodules were evaluated by C-TIRADS, ACR-TIRADS, EU-TIRADS, K-TIRADS, and Kwak-TIRADS, respectively. With pathology as gold standard, the diagnostic performance was evaluated by ROC curve and the area under the ROC curve(AUC). At the best cut-off value, the consistency was evaluated through the Kappa statistics. Results The AUC of C-TIRADS was higher than ACR-TIRADS, EU-TIRADS, K-TIRADS, and Kwak-TIRADS(0.812 vs. 0.751, 0.733, 0.733, 0.737, P<0.000 1), and all of them had good diagnostic efficiency. The best cut-off points for each TIRADS were C-TIRADS>4 b, ACR-TIRADS>4, EU-TIRADS>4, K-TIRADS>4, Kwak-TIRADS>4 b. The diagnostic results of C-TIRADS and ACR-TIRADS(Kappa=0.779), C-TIRADS and Kwak-TIRADS(Kappa=0.611) had better consistency, while the diagnostic results of C-TIRADS and K-TIRADS(Kappa=0.552), EU-TIRADS(Kappa=0.545) had medium consistency, P<0.000 1. Conclusions The C-TIRADS has high diagnostic value for thyroid nodules which is suitable for sonographic malignancy risk stratification of thyroid nodules.更多还原