arXiv:2602.00990eess.IV2026-02

加了动态视频没提高甲状腺结节诊断准确率,静态图已够用。

Diagnostic Impact of Cine Clips for Thyroid Nodule Assessment on Ultrasound

  • 对比静态图和动态视频,评估结节良恶性
  • 敏感度与特异度无显著提升,管理建议也一致
  • 适合临床医生参考,尤其关注指南是否必要加视频

背景:甲状腺超声常结合静态图像与动态视频(cine clips)进行。但动态影像的实际价值尚不明确。本研究旨在评估动态成像对甲状腺结节评估准确性与一致性的影响,采用美国放射学会甲状腺报告与数据系统(ACR TI-RADS)。方法:纳入50个良性与50个恶性结节,均经细胞病理学证实。由4名专科放射科医师分三轮阅读:前两轮仅看静态图像,第三轮加入静态与动态图像。比较不同条件下TI-RADS评分及管理建议与结节恶性程度的一致性。结果:恶性检出的平均敏感度为0.65(仅静态)和0.67(含动态),特异度分别为0.20和0.22,差异均不显著(p>0.5)。管理建议在有无动态图像时基本一致。各阅片者内部特征判读一致性稳定,但加入动态图像后TI-RADS总分略高。结论:在甲状腺结节超声评估中,增加动态影像未显著改善诊断性能。当前不强制使用动态视频的临床指南仍足以保证准确诊断。

原文摘要 · Abstract (English)

Background: Thyroid ultrasound is commonly performed using a combination of static images and cine clips (video recordings). However, the exact utility and impact of cine images remains unknown. This study aimed to evaluate the impact of cine imaging on accuracy and consistency of thyroid nodule assessment, using the American College of Radiology Thyroid Reporting and Data System (ACR TI-RADS). Methods: 50 benign and 50 malignant thyroid nodules with cytopathology results were included. A reader study with 4 specialty-trained radiologists was then conducted over 3 rounds, assessing only static images in the first two rounds and both static and cine images in the third round. TI-RADS scores and the consequent management recommendations were then evaluated by comparing them to the malignancy status of the nodules. Results: Mean sensitivity for malignancy detection was 0.65 for static images and 0.67 with both static and cine images (p>0.5). Specificity was 0.20 for static images and 0.22 with both static and cine images (p>0.5). Management recommendations were similar with and without cine images. Intrareader agreement on feature assignments remained consistent across all rounds, though TI-RADS point totals were slightly higher with cine images. Conclusion: The inclusion of cine imaging for thyroid nodule assessment on ultrasound did not significantly change diagnostic performance. Current practice guidelines, which do not mandate cine imaging, are sufficient for accurate diagnosis.

超声诊断甲状腺结节影像评估

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