高璐滢;姜玉新;李建初;张波;王莹;刘如玉;席雪华;高琼;杨筱;赖兴建;朱沈玲;张晓燕;赵瑞娜;
GAO Lu-ying;JIANG Yu-xin;LI Jian-chu;ZHANG Bo;WANG Ying;LIU Ru-yu;XI Xue-hua;GAO Qiong;YANG Xiao;LAI Xing-jian;ZHU Shen-ling;ZHANG Xiao-yan;ZHAO Rui-na;Department of Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;

• 1:中国医学科学院北京协和医学院北京协和医院超声医学科

摘要(Abstract)：

目的评估应用标准化甲状腺结节超声培训-考核系统的短期教学效果。方法 2017年12月,面向北京协和医院超声医学科培训学员,先采用标准化甲状腺结节超声培训-考核系统中的考核系统对学员进行考核,考察内容为甲状腺结节超声特征识别及恶性风险分级,然后采用该系统的培训部分对其进行相应培训,培训后12 h和1个月分别再次采用该系统对所有学员进行考核,系统自动记录考核得分情况,比较培训前后得分差异。结果共12名学员进入本研究,既往均接受过甲状腺疾病超声诊断的专业培训。在接受甲状腺结节超声培训后12 h及1个月,学员考核成绩均较培训前显著提高[(80.7±7.3)分比(69.9±4.0)分,P<0.01;(78.0±9.2)分比(69.9±4.0)分,P<0.05],且培训后12 h甲状腺结节各项超声特征及分级的诊断得分均较培训前显著提高(P<0.05)。与培训后12 h相比,培训后1个月学员考核成绩未明显下降(P>0.05)。结论标准化甲状腺结节超声培训-考核系统可在短期内提高学员甲状腺结节超声诊断能力,为推动甲状腺结节超声诊断的规范化教学提供了新思路。
Objective The purpose of this study was to explore the value of short-term training in the standardized training and examining system of thyroid nodule ultrasound. Methods We prospectively recruited trainees who were trained in the Department of Ultrasound, Peking Union Medical College Hospital in December 2017, and then assessed using the standardized training and examining system of thyroid nodule ultrasound. The ultrasonic characteristics and malignant risk classification of thyroid nodules were investigated. The scores were automatically recorded by the system. The training part of the system was then used for corresponding training. After twelve hours and one month, the system was used again to evaluate all participants, and the differences in scores before and after training were compared.Results A total of 12 participants were enrolled in this study,and all had received professional training in the ultrasonic diagnosis of thyroid diseases. The results of thyroid nodule reading were significantly improved after 12 hours and one month(80.7±7.3 vs. 69.9±4.0,P<0.01;78.0±9.2 vs. 69.9±4.0,P<0.05). The diagnostic ability of recognition of ultrasonic features and thyroid node classification was improved(P<0.05). Compared with the results 12 hours after training, the diagnostic level of thyroid nodule ultrasound did not drop significantly one month later(P> 0.05). Conclusions The standardized training and examining system of thyroid nodule ultrasound can improve trainees' ability to diagnose thyroid nodules with ultrasound in a short time, and at the same time, it provides new teaching methods for the standardization process of thyroid ultrasound in the future.

关键词(KeyWords)： 甲状腺结节;超声;标准化培训考核系统
thyroid nodule;ultrasound;standardized training and examining system

Abstract:

Keywords:

基金项目(Foundation): 国家国际科技合作专项(2015DFA30440);; 首都卫生发展科研专项(2016-2-40110);; 北京协和医学院教育教学改革项目(2016zlgc0108)

作者(Author): 高璐滢;姜玉新;李建初;张波;王莹;刘如玉;席雪华;高琼;杨筱;赖兴建;朱沈玲;张晓燕;赵瑞娜;
GAO Lu-ying;JIANG Yu-xin;LI Jian-chu;ZHANG Bo;WANG Ying;LIU Ru-yu;XI Xue-hua;GAO Qiong;YANG Xiao;LAI Xing-jian;ZHU Shen-ling;ZHANG Xiao-yan;ZHAO Rui-na;Department of Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;

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DOI:

参考文献(References)：

• [1] Guth S,Theune U,Aberle J,et al.Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination[J].Eur J Clin Invest,2009,39:699- 706.
• [2] Tan GH,Gharib H.Thyroid Incidentalomas:Management Approaches to Nonpalpable Nodules Discovered Incidentally on Thyroid Imaging[J].Ann Intern Med,1997,126:226- 231.
• [3] Hegedüs L.The thyroid nodule[J].New Engl J Med,2004,351:1764- 1771.
• [4] Leenhardt L,Erdogan MF,Hegedus L,et al.European Thyroid Association Guidelines for Cervical Ultrasound Scan and Ultrasound-Guided Techniques in the Postoperative Management of Patients with Thyroid Cancer[J].Eur Thyroid J,2013,2:147- 159.
• [5] Perros P,Boelaert K,Colley S,et al.British Thyroid Association Guidelines for the Management of Thyroid Cancer[J].Clin Endocrinol (Oxf),2014,81:1- 122.
• [6] Tessler FN,Middleton WD,Grant EG,et al.ACR Thyroid Imaging,Reporting and Data System (TI-RADS):White Paper of the ACR TI-RADS Committee[J].J Am Coll Radiol,2017,14:587.
• [7] Haugen BR,Alexander EK,Bible KC,et al.2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer:The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer[J].Thyroid,2016,26:1- 133.
• [8] Kwak JY,Han KH,Yoon JH,et al.Thyroid Imaging Reporting and Data System for US Features of Nodules:A Step in Establishing Better Stratification of Cancer Risk[J].Radiology,2011,260:892- 899.
• [9] Park CS,Kim SH,Jung SL,et al.Observer variability in the sonographic evaluation of thyroid nodules[J].J Clin Ultrasound,2010,38:287.
• [10] Satya SMN,Amogh VN,Satya GM,et al.A Prospective Study to Evaluate the Reliability of Thyroid Imaging Reporting and Data System in Differentiation between Benign and Malignant Thyroid Lesions[J].J Clin Imaging Sci,2016,6:5.