%0 Journal Article %T ACR TI-RADS分类对甲状腺髓样癌的诊断价值<br>Diagnostic value of ACR TI-RADS classification for medullary thyroid carcinoma %A 刘昱含 %A 王 %A 雁 %A 郭晓霞 %A 王成增 %J 郑州大学学报（医学版） %D 2018 %R 10.13705/j.issn.1671-6825.2018.04.008 %X 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。<br>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 %K 甲状腺髓样癌 %K 甲状腺头状癌 %K 超声检查 %K 甲状腺影像报告和数据系统< %K br> %K medullary thyroid carcinoma %K papillary thyroid carcinoma %K ultrasonography %K TI-RADS %U http://jms.zzu.edu.cn/oa/darticle.aspx?type=view&id=201806029