Interobserver agreement of Thyroid Imaging Reporting and Data System (TIRADS) and strain elastography for the assessment of thyroid nodules.
Interobserver agreement of Thyroid Imaging Reporting and Data System (TIRADS) and strain elastography for the assessment of thyroid nodules.
复制标题
DOI：
10.1371/journal.pone.0077927
复制
发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Bojunga J
中科院分区：
文献类型：
--
作者：
Friedrich-Rust M;Meyer G;Dauth N;Berner C;Bogdanou D;Herrmann E;Zeuzem S;Bojunga J
甲状腺成像报告和数据系统 (TIRADS) 的开发旨在通过避免对甲状腺结节患者进行不必要的细针抽吸活检 (FNAB) 来改善患者管理和成本效益。但其临床应用仍十分有限。应变弹性成像 (SE) 能够确定组织弹性，并在甲状腺结节的分化方面显示出有希望的结果。本研究的目的是评估 Horvath 等人开发的 TIRADS 的观察者间一致性 (IA)。和SE。三名盲法观察者独立对 114 个甲状腺结节（114 名患者）的 TIRADS 和 SE 存储图像进行评分。细胞学和/或组织学适用于所有良性结节 (n = 99)，组织学适用于所有恶性结节 (n = 15)。 3 位观察者之间的 IA 仅对 TIRADS 类别 2-5 (Coheńs kappa = 0.27,p = 0.000001) 和 TIRADS 类别 2/3 与 4/5 (ck = 0.25,p = 0.0020) 公平。对于 SE 分数 1-4 (ck = 0.66,p<0.000001)，IA 相当大，对于 SE 分数 1/2 与 3/4 (ck = 0.81,p<0.000001) 非常好。 92-100% 的 TIRADS-2 患者有良性病变，而 28-42% 的 TIRADS-5 患者有恶性细胞学/组织学病变。对于恶性肿瘤的诊断，使用 TIRADS 类别 4 和 5 的 TIRADS 的阴性预测值 (NPV) 为 92-100%，使用 ES-3 和 4 评分的 SE 的阴性预测值 (NPV) 分别为 96-98%。然而，只有 11-42% 的结节属于 TIRADS 2 类和 3 类，而 ES-1 类和 2 类的结节为 58-60%。 Horvath 等人开发的 TIRADS IA。才公平。 TIRADS 和 SE 在甲状腺结节的诊断检查中排除恶性肿瘤的 NPV 较高。
Thyroid Imaging Reporting and Data System (TIRADS) was developed to improve patient management and cost-effectiveness by avoiding unnecessary fine needle aspiration biopsy (FNAB) in patients with thyroid nodules. However, its clinical use is still very limited. Strain elastography (SE) enables the determination of tissue elasticity and has shown promising results for the differentiation of thyroid nodules. The aim of the present study was to evaluate the interobserver agreement (IA) of TIRADS developed by Horvath et al. and SE. Three blinded observers independently scored stored images of TIRADS and SE in 114 thyroid nodules (114 patients). Cytology and/or histology was available for all benign (n = 99) and histology for all malignant nodules (n = 15). The IA between the 3 observers was only fair for TIRADS categories 2–5 (Coheńs kappa = 0.27,p = 0.000001) and TIRADS categories 2/3 versus 4/5 (ck = 0.25,p = 0.0020). The IA was substantial for SE scores 1–4 (ck = 0.66,p<0.000001) and very good for SE scores 1/2 versus 3/4 (ck = 0.81,p<0.000001). 92–100% of patients with TIRADS-2 had benign lesions, while 28–42% with TIRADS-5 had malignant cytology/histology. The negative-predictive-value (NPV) was 92–100% for TIRADS using TIRADS-categories 4&5 and 96–98% for SE using score ES-3&4 for the diagnosis of malignancy, respectively. However, only 11–42% of nodules were in TIRADS-categories 2&3, as compared to 58–60% with ES-1&2. IA of TIRADS developed by Horvath et al. is only fair. TIRADS and SE have high NPV for excluding malignancy in the diagnostic work-up of thyroid nodules.
登录
查看更多内容
影响因子：
6.6
作者：
Park, Ji-Young;Lee, Hui Joong;Kim, Seong Hun
通讯作者：
Kim, Seong Hun
影响因子：
5.4
作者：
Gharib, H.;Papini, E.;Vitti, P.
通讯作者：
Vitti, P.
影响因子：
5
作者：
Lim, Dong-Jun;Luo, Si;Kim, Yongmin
通讯作者：
Kim, Yongmin
影响因子：
6.6
作者：
Bojunga, Joerg;Herrmann, Eva;Friedrich-Rust, Mireen
通讯作者：
Friedrich-Rust, Mireen
影响因子：
3.3
作者：
Ning, Chun-Ping;Jiang, Shuang-Quan;Tian, Jia-Wei
通讯作者：
Tian, Jia-Wei