OBJECTIVE:To evaluate diagnostic value of Thyroid Imaging Reporting and Data System published by American College of Radiology (ACR TI-RADS) in 2017, ultrasound-guided fine-needle aspiration (US-FNA), and the combination of both methods in differentiation between benign and malignant thyroid nodules. METHODS:The data of US-FNA and ACR TI-RADS are collected from 159 patients underwent thyroid surgery in our hospital, which include a total of 178 thyroid nodules. A Bethesda System for Reporting Thyroid Cytopathology category of ≥IV and an ACR TI-RADS category ≥4 are regarded as diagnosis standards for malignancy in US-FNA and ACR TI-RADS, respectively. The pathological results after surgery are considered as the gold standard. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the ACR TI-RADS, US-FNA and the combination of both methods for the differential diagnosis of thyroid nodules are calculated, respectively. RESULTS:The sensitivity, specificity and accuracy of ACR TI-RADS are 85.4%, 37.5%and 72.5%, respectively. The sensitivity, specificity and accuracy of US-FNA are 70.0%, 100%and 78.1%, respectively. After combining these two methods, the sensitivity, specificity and accuracy increase to 99.23%, 37.50%and 82.58%, respectively. The sensitivity of ACR TI-RADS is higher than that of US-FAN, and the sensitivity of combining these two methods is also higher than that of using ACR TI-RADS and US-FNA alone. CONCLUSION:The established ACR TI-RADS can help in selecting the target during nodule puncture, while the combination of ACR TI-RADS and US-FAN can further improve diagnostic ability for detecting malignant thyroid nodules.

中文翻译：

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2017 ACR甲状腺影像报告和数据系统（TI-RADS）联合细针穿刺活检对甲状腺结节的诊断价值

目的：评价美国放射学会（ACR TI-RADS）2017年发布的甲状腺成像报告和数据系统、超声引导下细针穿刺（US-FNA）以及这两种方法的结合在鉴别诊断中的价值。良性和恶性甲状腺结节。方法：收集我院159例甲状腺手术患者的US-FNA和ACR TI-RADS数据，其中甲状腺结节178个。用于报告甲状腺细胞病理学类别≥IV 和 ACR TI-RADS 类别≥4 的 Bethesda 系统分别被视为 US-FNA 和 ACR TI-RADS 中恶性肿瘤的诊断标准。手术后的病理结果被认为是金标准。ACR TI-RADS的敏感性、特异性、准确性、阳性​​预测值和阴性预测值，分别计算US-FNA和两种方法联合用于甲状腺结节的鉴别诊断。结果：ACR TI-RADS的敏感性、特异性和准确性分别为85.4%、37.5%和72.5%。US-FNA的敏感性、特异性和准确性分别为70.0%、100%和78.1%。将这两种方法结合后，灵敏度、特异度和准确度分别提高到99.23%、37.50%和82.58%。ACR TI-RADS的灵敏度高于US-FAN，这两种方法结合的灵敏度也高于单独使用ACR TI-RADS和US-FNA的灵敏度。结论：建立的ACR TI-RADS有助于结节穿刺时靶点的选择，ACR TI-RADS与US-FAN联合应用可进一步提高甲状腺恶性结节的诊断能力。