显著低声:新的定义提高了甲状腺超声波的诊断性能
Juan Liu1, Ting Luo1, Hua Zhang2
1Department of Ultrasound, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Er Rd, Shanghai, 200025, China.
European radiology
|June 20, 2023
概括
对明显低声超声检测结果的修改定义显著提高了诊断恶性甲状腺结节的准确性. 这种增强的标准也提高了癌症成像-甲状腺 (C-TIRADS) 风险分层系统的性能.
科学领域:
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
- 医疗成像医学成像
背景情况:
- 甲状腺结节的特征依赖于超声波 (US) 的特征,包括回声性.
- 对明显低声结节的定义对于恶性瘤的评估至关重要.
- 美国定义的变化可能会影响诊断的准确性.
研究的目的:
- 为了评估一个修改的定义的诊断贡献明显的低声在区分恶性和良性甲状腺结节.
- 评估这一修改后的定义对已建立的风险分层系统 (如ACR-TIRADS,EU-TIRADS和C-TIRADS) 的影响.
主要方法:
- 从一个多中心研究中对1031个甲状腺结节进行了回顾性分析.
- 经典和修改定义的明显低声美国特征的比较.
- 计算和比较恶性瘤检测的灵敏度,特异性和AUC.
- 对修改后的定义进行观察者间和观察者内部变异性的评估.
主要成果:
- 与古典定义相比,修改后明显低声的定义显著增加了恶性瘤检测的敏感性 (63.26%vs.28.03%) 和AUC (0.741vs0.598).
- 随着修改后的定义,特异性显著下降 (84.88%与91.53%)
- 在C-TIRADS表现出改善的AUC与修改显著低音定义 (0.888对比0.878,p=0.01).
- 对于修改后的定义,观察者之间存在实质性的和观察者内部存在完美的一致性.
结论:
- 显著低音的修改定义显著提高了恶性甲状腺结节的诊断性能.
- 这一修改提高了风险分层系统的预测效率,特别是C-TIRADS.
- 修改后的定义提供了一个更敏感的方法来识别潜在的恶性甲状腺病变.
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