[1]刘昱含,王 雁,郭晓霞,等.ACR TI-RADS分类对甲状腺髓样癌的诊断价值[J].郑州大学学报(医学版),2018,(06):816-820.[doi:10.13705/j.issn.1671-6825.2018.04.008]
 LIU Yuhan,WANG Yan,GUO Xiaoxia,et al.Diagnostic value of ACR TI-RADS classification for medullary thyroid carcinoma[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2018,(06):816-820.[doi:10.13705/j.issn.1671-6825.2018.04.008]
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ACR TI-RADS分类对甲状腺髓样癌的诊断价值()
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2018年06期
页码:
816-820
栏目:
应用研究
出版日期:
2018-11-20

文章信息/Info

Title:
Diagnostic value of ACR TI-RADS classification for medullary thyroid carcinoma
作者:
刘昱含王 雁郭晓霞王成增
郑州大学附属肿瘤医院(河南省肿瘤医院)超声科 郑州 450008
Author(s):
LIU YuhanWANG YanGUO Xiaoxia WANG Chengzeng
Department of Ultrasound,the Affiliated Tumor Hospital,Zhengzhou University(Henan Tumor Hospital),Zhengzhou 450008
关键词:
甲状腺髓样癌 甲状腺头状癌 超声检查 甲状腺影像报告和数据系统
Keywords:
medullary thyroid carcinoma papillary thyroid carcinoma ultrasonography TI-RADS
分类号:
R445.1
DOI:
10.13705/j.issn.1671-6825.2018.04.008
摘要:
目的:探讨美国放射学会(ACR)制定的甲状腺影像报告和数据系统(TI-RADS)在甲状腺髓样癌(MTC)中的诊断价值。方法:根据TI-RADS分类标准对术后病理证实的297例甲状腺结节进行分类,其中MTC 48例,甲状腺乳头状癌(PTC)142例,良性结节107例,回顾性分析PTC和MTC的超声征象差异。结果:TI-RADS分类诊断PTC的敏感度、特异度、准确率分别为79.6%、89.7%和83.9%; 诊断MTC的敏感度、特异度、准确率分别为66.7%、89.7%、和82.6%; PTC和MTC的ROC曲线下面积分别为0.929(0.895~0.963)和0.853(0.790~0.915),差异有统计学意义,P=0.018)。两名超声医师TI-RADS分类结果一致性较高(Kappa=0.958,P<0.001)。MTC和PTC在肿瘤大小、边界、形态、纵横比方面的差异有统计学意义(P<0.05)。结论:TI-RADS分类对MTC的诊断效能低于PTC,MTC具有一些特异的超声征象。
Abstract:
Aim:To explore the diagnostic value of the thyroid imaging reporting and data system(TI-RADS)in medullary thyroid carcinoma(MTC)which set by the the American College of Radiology(ACR).Methods:A total of 297 cases of thyroid nodule proved by postoperative pathology were classified by the standard of TI-RADS, out of which there were 48 cases of MTC, 142 cases of papillary thyroid carcinoma(PTC), and 107 cases of benign nodule,and the differences between PTC and MTC in ultrasonic signs were retrospectively analyzed.Results:The sensitivity,specificity,and accuracy of TI-RADS classification for PTC were 79.6%,89.7% and 83.9%, respectively,while those for MTC were 66.7%,89.7%,and 71.0%, respectively.The area under ROC curve of TI-RADS classification for PTC and MTC was 0.929(0.895-0.963)and 0.853(0.790-0.915), respectively,and the difference was significant(P=0.018).The consistency of the evaluation results of the two ultrasound physicians was high(Kappa=0.958,P<0.001)according to TI-RADS classification.The differences between MTC and PTC in tumor size, boundary, morphology and aspect ratio were significant(P<0.05).Conclusion:The diagnosis efficiency of TI-RADS classification for MTC is lower than that for PTC.The specific ultrasonic signs of MTC would be helpful for preoperative diagnosis of MTC.

参考文献/References:

[1] HAZARD JB,HAWK WA,CRILE G.Medullary(solid)carcinoma of the thyroid; a clinicopathologic entity[J].J Clin Endocrinol Metab,1959,19(1):152
[2] GANESHAN D,PAULSON E,DURAN C,et al.Current update on medullary thyroid carcinoma[J].AJR Am J Roentgenol,2013,201(6):W867
[3] 卢秀波,耿祖仕,刘洋,等.甲状腺结节的超声TI-RADS诊断[J].郑州大学学报(医学版),2013,48(2):277
[4] HORVATH E,MAJLIS S,ROSSI R,et al.An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management[J].J Clin Endocrinol Metab,2009,94(5):1748
[5] TESSLER FN,MIDDLETON WD,GRANT EG,et al.ACR Thyroid Imaging, Reporting and Data System(TI-RADS): White Paper of the ACR TI-RADS Committee[J].J Am Coll Radiol,2017,14(5):587
[6] ACCARDO G,CONZO G,ESPOSITO D,et al.Genetics of medullary thyroid cancer:an overview[J].Int J Surg,2017,41(Suppl 1):S2
[7] MATIAS-GUIU X,DE LELLIS R.Medullary thyroid carcinoma: a 25-year perspective[J].Endocr Pathol,2014,25(1):21
[8] 袁玉洁,陆凡倩,张淑君,等.甲状腺髓样癌的超声鉴别诊断及临床意义[J].中国耳鼻咽喉头颈外科,2015,22(4):163
[9] 张新华,高峰,张学兰,等.声触诊组织量化技术定量分析甲状腺结节良恶性初步探析[J].兰州大学学报(医学版),2015,41(4):32
[10]ZHOU LG,CHEN B,ZHAO MQ,et al.Sonographic features of medullary thyroid carcinomas according to tumor size: comparison with papillary thyroid carcinomas[J].J Ultrasound Med,2015,34(6):1003
[11]TRIMBOLI P,NASROLLAH N,AMENDOLA S,et al.Should we use ultrasound features associated with papillary thyroid cancer in diagnosing medullary thyroid cancer?[J].Endocr J,2012,59(6):503
[12]赵静,赵利辉,忻晓洁,等.甲状腺滤泡癌与甲状腺乳头状癌的TI-RADS分类及超声特征分析[J].中华普通外科杂志,2016,31(9):754
[13]WOLIÑSKI K,REWAJ-OSYK M,RUCHAA M.Sonographic features of medullary thyroid carcinomas:a systematic review and meta-analysis[J].Endokrynol Pol,2014,65(4):314
[14]朱佳琳,赵静,魏玺,等.改良甲状腺影像报告及数据系统在甲状腺髓样癌诊断中的价值[J].中华肿瘤杂志,2017,39(8):618

备注/Memo

备注/Memo:
【基金项目】河南省科技攻关基金资助项目(172102410012)
【作者简介】王成增,通信作者,男,1964年10月生,博士,教授,研究方向:超声诊断,E-mail:czwang1022@163.com
更新日期/Last Update: 2018-11-20