Comparison of the diagnostic efficacy of C-TIRADS and ACR TIRADS for benign and malignant thyroid nodules

Wang Guixia; Lu Qiyong; Liu Cancan; Fan Kuanlu; Xu Shuhang; Liu Chao; Zhang Daowen

doi:10.13406/j.cnki.cyxb.003135

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Comparison of the diagnostic efficacy of C-TIRADS and ACR TIRADS for benign and malignant thyroid nodules

The management of thyroid cancer | 更新时间：2025-10-21

- Comparison of the diagnostic efficacy of C-TIRADS and ACR TIRADS for benign and malignant thyroid nodules
- Journal of Chongqing Medical University Vol. 47, Issue 11, Pages: 1278-1281(2022)
- 作者机构：
  
  1.徐州医科大学第二附属医院，内分泌科
  2.超声科，徐州 221000
  3.江苏省中西医结合医院内分泌科，南京 210028
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003135
  CLC： R581.1
- Received：25 April 2022，
  
  Published：28 November 2022
- 稿件说明：
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王桂霞,陆启勇,刘灿灿,等.C-TIRADS与ACR TIRADS对判断甲状腺结节良恶性的诊断效能比较[J].重庆医科大学学报,2022,47(11):1278-1281.

Wang Guixia,Lu Qiyong,Liu Cancan,et al.Comparison of the diagnostic efficacy of C-TIRADS and ACR TIRADS for benign and malignant thyroid nodules[J].Journal of Chongqing Medical University,2022,47(11):1278-1281.
王桂霞,陆启勇,刘灿灿,等.C-TIRADS与ACR TIRADS对判断甲状腺结节良恶性的诊断效能比较[J].重庆医科大学学报,2022,47(11):1278-1281. DOI： 10.13406/j.cnki.cyxb.003135.

Wang Guixia,Lu Qiyong,Liu Cancan,et al.Comparison of the diagnostic efficacy of C-TIRADS and ACR TIRADS for benign and malignant thyroid nodules[J].Journal of Chongqing Medical University,2022,47(11):1278-1281. DOI： 10.13406/j.cnki.cyxb.003135.

摘要

目的

比较中华医学会超声医学分会甲状腺影像报告和数据系统（C-TIRADS）与美国放射学会甲状腺影像报告和数据系统（ACR TIRADS）对甲状腺结节良恶性的诊断效能。

方法

回顾性分析321枚行甲状腺细针穿刺的甲状腺结节，统计穿刺后结节声像图资料，使用C-TIRADS指南、ACR TIRADS指南进行结节再次评估，构建二者的受试者工作特征（receiver operating characteristic，ROC）曲线，计算二者灵敏度、特异度、准确度，比较二者在甲状腺结节诊断中的效能。

结果

C-TIRADS指南甲状腺结节恶性风险为：2类0.0%（0/10），3类5.0%（1/20），4a类17.3%（22/127），4b类44.3%（43/97），4c类74.4%（32/43），5类91.7%（22/24）；ACR TIRADS指南为：2类4.3%（1/22），3类3.4%（2/58），4类35.9%（52/145），5类64.6%（62/96）。C-TIRADS指南和ACR TIRADS指南的曲线下面积（area under the curve，AUC）分别为0.798（95%CI=0.749~0.840）、0.765（95%CI=0.715~0.810），二者差异无统计学意义（

=0.081），约登指数最大值分别为0.467、0.382，对应的最佳截断值分别为C-TIRADS4a、ACR-TIRADS 4类；C-TIRADS的灵敏度、特异度、准确度分别为81.82%、84.00%、83.18%，ACR TIRADS的灵敏度、特异度、准确度分别为81.82%、60.00%、68.22%，C-TIRADS较ACR TIRADS特异度、准确度更高，差异有统计学意义（

=0.000，

=0.000），二者灵敏度差异无统计学意义（

=1.000）。

结论

C-TIRADS较ACR TIRADS在甲状腺结节诊断中具有更高的特异度和准确度。

Abstract

Objective

To compare the diagnostic efficacy of C-TIRADS and ACR TIRADS for benign and malignant thyroid nodules.

Methods

A retrospective analysis was performed on 321 thyroid nodules undergoing fine needle aspiration. The data of ultrasonographic image were collected. Ultrasonic physicians re-graded all nodules by C-TIRADS guideline and ACR TIRADS guideline. The receiver operating characteristic（ROC） curve of them was constructed，and the sensitivity，specificity and accuracy of C-TIRADS and ACR TIRADS were calculated and their diagnostic efficacy for thyroid nodules were compared.

Results

By C-TIRADS guideline，the risks of malignant thyroid nodules were as follows：

0.0%（0/10） in category 2，5.0%（1/20） in category 3，17.3%（22/127） in category 4a，44.3%（43/97） in category 4b，74.4%（32/43） in category 4c，and 91.7%（22/24）in category 5. By ACR TIRADS： 4.3%（1/22） in category 2，3.4%（2/58） in category 3，35.9%（52/145） in category 4，and 64.6%（62/96） in category 5. The area under curve（AUC） of C-TIRADS and ACR TIRADS were 0.798（95%CI=0.749–0.840） and 0.765（95%CI=0.715–0.810），respectively，without statistically significant difference（

=0.081）. The maximum value of the Youden index was 0.467 and 0.382，and the corresponding cutoff values were C-TIRADS 4a and ACR-TIRADS 4，respectively. The sensitivity，specificity and accuracy of C-TIRADS were 81.82%，84.00% and 83.18%，respectively，and those of ACR TIRADS were 81.82%，60.00% and 68.22% respectively. The specificity and accuracy of C-TIRADS were higher than those of ACR TIRADS，and the difference was statistically significant（

=0.000，

=0.000），but there was no statistically significant difference in sensitivity（

=1.000）.

Conclusion

C-TIRADS has better specificity and accuracy than ACR TIRADS in diagnosis of thyroid nodules.

关键词

Keywords

references

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