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目的探讨甲状腺影像报告和数据系统(TI-RADS)诊断甲状腺良、恶性结节的价值。方法回顾性分析经术后病理证实甲状腺结节患者417例(573个结节)的临床资料。其中,恶性结节组患者246例(299个结节),良性结节组患者171例(274个结节)。根据TI-RADS系统将结节进行危险因素分层绘制TI-RADS的ROC曲线,测定AUC,计算诊断灵敏度、特异度、阳性预测值和阴性预测值。结果甲状腺结节TI-RADS 2、3、4、5级的恶性率分别为0、13.39%(17/127)、67.14%(47/70)、89.35%(235/263),组间差异有统计学意义(P<0.01)。ROC曲线分析显示,TI-RADS诊断良、恶性结节的最佳诊断界点为3级,诊断甲状腺良、恶性结节的灵敏度为95.99%,特异度为81.02%,阳性预测值为84.70%,阴性预测值为94.90%。结论 TI-RADS危险因素分层系统用于诊断甲状腺良、恶性结节具有较高的应用价值。
Objective To investigate the value of thyroid imaging report and data system (TI-RADS) in the diagnosis of benign and malignant thyroid nodules. Methods The clinical data of 417 patients (573 nodules) with thyroid nodules confirmed by postoperative pathology were retrospectively analyzed. Among them, 246 patients (299 nodules) in the malignant nodule group and 171 patients (274 nodules) in the benign nodule group. ROC curves of TI-RADS were stratified according to TI-RADS system, and AUC was calculated. Diagnostic sensitivity, specificity, positive predictive value and negative predictive value were calculated. Results The malignant rates of grade 2, 3, 4 and 5 of thyroid nodules were 0, 13.39% (17/127), 67.14% (47/70) and 89.35% (235/263), respectively Statistical significance (P <0.01). ROC curve analysis showed that TI-RADS diagnosis of benign and malignant nodules the best diagnostic threshold for grade 3, the diagnosis of benign and malignant thyroid nodules sensitivity was 95.99%, specificity was 81.02%, the positive predictive value was 84.70% The negative predictive value was 94.90%. Conclusion TI-RADS stratified risk factors for the diagnosis of benign and malignant thyroid nodules has a high value.