甲状腺超声波操作人员在定义甲状腺结节为子囊方面达成了观察者间的协议
Pierpaolo Trimboli1,2, Enrico Papini3, Jörg Bojunga4
1Thyroid Unit, Clinic for Endocrinology and Diabetology, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland.
Thyroid : official journal of the American Thyroid Association
|August 25, 2025
概括
通过超声波对甲状腺亚囊结节 (TNs) 的分类达成一致. 需要标准化定义来提高对癌症风险的评估和指导治疗决策的一致性.
科学领域:
- 放射学
- 内分泌学
- 癌症学
背景情况:
- 超声波 (US) 对于评估甲状腺结节 (TNs) 和指导细针吸收细胞学 (FNAC) 是至关重要的.
- 如果怀疑有恶性瘤,囊下TN位置可能会影响FNAC的决定,可能有利于手术而不是监测.
- 目前没有明确的亚囊性TN定义,导致诊断模两可.
研究的目的:
- 评估美国经验丰富的甲状腺专家之间的观察者间协议 (IOA),以分类TNs为亚囊或非.
- 识别可能影响亚囊TN评估变异性的US特征.
主要方法:
- 经验丰富的12名美国评估人员对60张美国静态图像进行了评估,以确定TN的分囊位置.
- 使用Fleiss' kappa计算了观察者之间的一致性,并分析了影响变异性的TN特征.
- 病例来自手术切除和组织学诊断的TNs.
主要成果:
- 在亚囊TN分类的整体IOA是公平的 (κ = 0. 34).
- 在经验较长的评价者 (κ = 0.39) 和中等规模的TN (κ = 0.38) 中观察到更高的IOA.
- 在被归类为EU- TIRADS 5且小于2厘米的TN中发现的IOA最高 (κ = 0. 46).
结论:
- 目前美国专家对评估亚囊性TN的IOA不令人满意.
- 为了改善临床决策,对亚囊性TN位置的标准化定义至关重要.
- 未来的指导方针应涉及对亚囊性TN进行一致的评估和管理.
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