评价tirads、eu-tirads、tla_ru系统在甲状腺结节病理超声诊断中的预测能力

V. G. Stepanov, L. A. Timofeeva, Sergey V. Alekseev, M. A. Yusova
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摘要

本研究的目的是评估EU-TIRADS、TIRADS、TLA_RU系统在甲状腺结节性肿块超声诊断中的预后能力。对665例患者进行超声检查方案的回顾性独立连续盲法研究,其中良性非癌性甲状腺疾病241例,良性肿瘤(腺瘤)86例,甲状腺癌338例。术前检查时,所有患者均按照标准程序对颈部器官进行多参数超声检查,登记已识别的甲状腺淋巴结,并检查分层系统-TIRADS, EU-TIRADS, TLA_RU的预后能力。结果表明,TIRADS系统灵敏度为91.04%,特异度为- 91.41%。从反映诊断试验质量的AUC值的尺度来看,可以说TIRADS是一项质量优良的试验(AUC =0.972)。对EU-TIRADS系统获得的数据进行分析,结果表明,EU-TIRADS是一种高质量的检测方法(AUC=0.826),但其预测能力不如TIRADS。原TLA_RU模型敏感性为87.5%,特异性为95.7%。ROC分析发现AUC = 0.954±0.00894,提示TLA_RU模型在甲状腺结节性肿块鉴别诊断中是一个质量优良的检验方法。从循证医学的角度对甲状腺影像学评估系统(TIRADS、EU-TIRADS和TLA_RU)进行多元统计比较分析表明,基于多参数超声征象评估的甲状腺癌风险分层系统具有较强的诊断能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
EVALUATION OF PREDICTIVE CAPABILITIES OF TIRADS, EU-TIRADS, TLA_RU SYSTEMS IN THE ULTRASOUND DIAGNOSIS OF THYROID NODULAR PATHOLOGY
The aim of the study was to evaluate the prognostic capabilities of EU-TIRADS, TIRADS, TLA_RU systems in ultrasound diagnostics of thyroid nodular masses. A retrospective independent continuous blind study of ultrasound examination protocols was conducted in 665 patients, 241 patients had benign non-cancerous thyroid diseases, 86 patients had benign tumors (adenomas), 338 patients had thyroid cancer. During the preoperative examination, all patients underwent a multiparametric ultrasound examination of the neck organs according to the standard procedure, with the registration of identified thyroid nodes, with examining the prognostic capabilities of stratification systems – TIRADS, EU-TIRADS, TLA_RU. It was found that the TIRADS system has a sensitivity of 91.04%, specificity – 91.41%. Focusing on the scale of AUC values reflecting the quality of the diagnostic test, it can be stated that TIRADS is a test with excellent quality (AUC =0.972). Basing on the results of the analyzing the data obtained by the EU-TIRADS system, it was revealed that it is a high-quality test (AUC=0.826), but its predictive capabilities are worse than those of TIRADS. The original TLA_RU model has 87.5% sensitivity and 95.7% specificity. During the ROC analysis, it was found that the AUC is equal to 0.954±0.00894, which suggests that the TLA_RU model is an excellent quality test in the differential diagnosis of thyroid nodular masses. Multivariate statistical comparative analysis of thyroid imaging assessment systems (TIRADS, EU-TIRADS and TLA_RU) from the standpoint of evidence-based medicine has shown that thyroid cancer risk stratification systems based on the assessment of multiparametric ultrasound signs have great diagnostic capabilities.
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