摘要目的：对比2017年美国放射学会甲状腺影像报告和数据系统（Thyroid imaging reporting and data system of ACR，ACR TI-RADS）与2011版Kwak甲状腺影像报告和数据系统（Thyroid imaging reporting and data system of Kwak，Kwak TI-RADS）在诊断甲状腺结节良恶性中的效能。方法：回顾分析305例患者319个甲状腺结节的常规超声图像结果，同时运用ACR TI-RADS和Kwak TI-RADS方法对上述结节进行分类，结果均以病理为参照标准进行统计学分析。结果：ACR TI-RADS诊断甲状腺结节良恶性的灵敏性为77.6%、特异性为83.0%、准确性为82.1%、阳性预测值为45.0%、阴性预测值为95.3%；Kwak TI-RADS诊断甲状腺结节良恶性的灵敏性为89.8%、特异性为81.1%、准确性为82.4%、阳性预测值为46.3%、阴性预测值为97.8%。对比显示两种方法无明显统计学差异。结论：①ACR TI-RADS和Kwak TI-RADS在甲状腺结节良恶性诊断中无明显差异，均具有良好的价值；②ACR TI-RADS进一步规范了甲状腺结节描述术语，提高了诊断一致性，并给予了甲状腺结节管理的建议。
Abstract：Objective: To compare the diagnostic efficacy between 2017 thyroid imaging reporting and data system of ACR(ACR TI-RADS) and 2011 thyroid imaging reporting and data system of Kwak(Kwak TI-RADS) in the diagnosis of benign or malignant thyroid nodules. Methods: The results of routine ultrasound images of 319 thyroid nodules in 305 patients were retrospectively analyzed, and these nodules were classified using ACR TI-RADS and Kwak TI-RADS methods, which were retrospectively analyzed with pathology as the reference standard. Results: In the diagnosis of benign or malignant thyroid nodules using ACR TI-RADS method, the sensitivity was 77.6%, specificity was 83.0%, accuracy was 82.1%, positive predictive value was 45.0% and negative predictive value was 95.3%. In the diagnosis of benign or malignant thyroid nodules using Kwak TI-RADS method, the sensitivity was 89.8%, specificity was 81.1%, accuracy was 82.4%, positive predictive value was 46.3% and negative predictive value was 97.8%. There was no significant difference between the two methods. Conclusion: ①There was no significant difference between ACR TI-RADS and Kwak TI-RADS in the diagnosis of benign or malignant thyroid nodules, and both of them had good diagnostic value. ②ACR TI-RADS further defined terms for the description of thyroid nodules, improved diagnostic consistency, and gave advice on thyroid nodule management.
姚建锋，张煜华，王全江，陈正雷. ACR TI-RADS与Kwak TI-RADS对比在甲状腺结节定性诊断中的效能[J]. 中国临床医学影像杂志, 2019, 30(8): 537-539.
YAO Jian-feng, ZHANG Yu-hua, WANG Quan-jiang, CHEN Zheng-lei. Comparison of diagnostic efficacy between ACR TI-RADS and Kwak TI-RADS in qualitative diagnosis of thyroid nodules. JOURNAL OF CHINA MEDICAL IMAGING, 2019, 30(8): 537-539.
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