不同风险分层系统在评估甲状腺结节的超声表现方面存在差异，导致关于诊断敏感性、特异性和准确性存在不一致和不确定性。本研究对过去五年中提出的不同超声风险分层系统的甲状腺癌诊断性能进行比较。我们在PubMed、EMBASE和Web of Science数据库中进行系统搜索，截至2022年12月8日，找到相关研究，研究内容包括上述任一超声风险分层系统（欧洲甲状腺成像报告和数据系统[Eu-TIRADS]；美国放射学学会TIRADS[ACR TIRADS]；中国版TIRADS[C-TIRADS]；基于深度学习的辅助诊断系统[S-Detect]）的诊断性能表述。根据组织病理学和细胞学的黄金诊断标准，进行单一统计分析，得出每个系统的最佳阈值，并在每个系统的最佳风险分层类别上进行网络荟萃分析。这个网络荟萃分析包括88个研究，总共涉及59304个结节。最准确的风险类别阈值为Eu-TIRADS的TR5，ACR TIRADS的TR5，C-TIRADS的TR4b及以上，以及S-Detect的可能恶性。在最佳阈值下，这些系统的敏感性在68%至82%之间，特异性在71%至81%之间。C-TIRADS的TR4b的敏感性最高，ACR TIRADS的TR5的特异性最高。然而，ACR TIRADS的TR5的敏感性是最低的。诊断比值比（DOR）和曲线下面积（AUC）在C-TIRADS中排名第一。在四个超声风险分层选项中，本系统评价初步证明C-TIRADS对甲状腺结节具有有利的诊断性能。详细信息可参见https://www.crd.york.ac.uk/prospero，CRD42022382818。版权所有 © 2023 杨、李、陈、何、王和刘。

The performance in evaluating thyroid nodules on ultrasound varies across different risk stratification systems, leading to inconsistency and uncertainty regarding diagnostic sensitivity, specificity, and accuracy.Comparing diagnostic performance of detecting thyroid cancer among distinct ultrasound risk stratification systems proposed in the last five years.Systematic search was conducted on PubMed, EMBASE, and Web of Science databases to find relevant research up to December 8, 2022, whose study contents contained elucidation of diagnostic performance of any one of the above ultrasound risk stratification systems (European Thyroid Imaging Reporting and Data System[Eu-TIRADS]; American College of Radiology TIRADS [ACR TIRADS]; Chinese version of TIRADS [C-TIRADS]; Computer-aided diagnosis system based on deep learning [S-Detect]). Based on golden diagnostic standard in histopathology and cytology, single meta-analysis was performed to obtain the optimal cut-off value for each system, and then network meta-analysis was conducted on the best risk stratification category in each system.This network meta-analysis included 88 studies with a total of 59,304 nodules. The most accurate risk category thresholds were TR5 for Eu-TIRADS, TR5 for ACR TIRADS, TR4b and above for C-TIRADS, and possible malignancy for S-Detect. At the best thresholds, sensitivity of these systems ranged from 68% to 82% and specificity ranged from 71% to 81%. It identified the highest sensitivity for C-TIRADS TR4b and the highest specificity for ACR TIRADS TR5. However, sensitivity for ACR TIRADS TR5 was the lowest. The diagnostic odds ratio (DOR) and area under curve (AUC) were ranked first in C-TIRADS.Among four ultrasound risk stratification options, this systemic review preliminarily proved that C-TIRADS possessed favorable diagnostic performance for thyroid nodules.https://www.crd.york.ac.uk/prospero, CRD42022382818.Copyright © 2023 Yang, Li, Chen, He, Wang and Liu.