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直径小于1.0厘米的甲状腺结节细针穿刺活检:甲状腺影像报告和数据系统(TIRADS)分类系统在1000多个结节中的准确性

Fine needle aspiration biopsy of thyroid nodule smaller than 1.0 cm: accuracy of TIRADS classification system in more than 1000 nodules.

作者信息

Mendes Guilherme F, Garcia Marcio Rt, Falsarella Priscila M, Rahal Antonio, Cavalcante Junior Francisco A, Nery Daniela R, Garcia Rodrigo G

机构信息

1 Department of Interventional Radiology, Hospital Israelita Albert Einstein , São Paulo , Brazil.

2 Department of Radiology, Hospital Israelita Albert Einstein , São Paulo , Brazil.

出版信息

Br J Radiol. 2018 Feb;91(1083):20170642. doi: 10.1259/bjr.20170642. Epub 2017 Dec 22.

Abstract

OBJECTIVE

To identify whether or not the same ultrasound features can be applied and should be considered to support the decision as to which subcentimeter nodules should be biopsied with fine needle aspiration (FNAB).

METHODS

Single-institution, IRB approved, retrospective study conducted from 2008 to 2016 that evaluated 1094 thyroid nodules smaller than 1.0 cm that were classified according to TIRADS and submitted for FNAB.

RESULTS

The value of FNAB of thyroid nodules smaller than 1.0 cm were assessed and correlated with the sonographic criteria by comparing the obtained results with the cytological findings in 1094 thyroid nodules. In the analysis considering all nodules, the proportion of malignancies among nodules with TIRADS 2 is 0.91% and for TIRADS 3 is 2.87%. Among those classified as 4A, 12.26%; with 4B classification, 34.43%; with 4C classification, 66.6%; and among those with 5 classifications, 85.7%.

CONCLUSION

In conclusion, the TIRADS classification system, based on the sonographic features reported herein, may help detect which nodules should be investigated for potential malignancies. Advances in knowledge: Few reports compare the efficacy of ultrasound-FNAB for thyroid nodules smaller than 1.0 cm in diameter. The findings of malignancy in this subgroup of nodules may help in the clinical follow-up of which patients should be submitted to an early imaging evaluation or intervention.

摘要

目的

确定相同的超声特征是否可用于支持决定哪些亚厘米级结节应接受细针穿刺活检(FNAB),以及是否应考虑这些特征来做出该决定。

方法

在2008年至2016年期间进行的一项单机构、经机构审查委员会批准的回顾性研究,评估了1094个直径小于1.0厘米的甲状腺结节,这些结节根据甲状腺影像报告和数据系统(TIRADS)进行分类并接受FNAB检查。

结果

通过将1094个甲状腺结节的超声检查结果与细胞学检查结果进行比较,评估了直径小于1.0厘米的甲状腺结节FNAB的价值,并将其与超声标准相关联。在对所有结节的分析中,TIRADS 2类结节的恶性比例为0.91%,TIRADS 3类结节为2.87%。在分类为4A的结节中,恶性比例为12.26%;4B类为34.43%;4C类为66.6%;5类结节中为85.7%。

结论

总之,基于本文报告的超声特征的TIRADS分类系统可能有助于检测哪些结节应进行潜在恶性肿瘤的调查。知识进展:很少有报告比较超声引导下FNAB对直径小于1.0厘米的甲状腺结节的疗效。该亚组结节的恶性发现可能有助于临床随访,确定哪些患者应接受早期影像学评估或干预。

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