Drake Tyler, Gravely Amy, Westanmo Anders, Billington Charles
Department of Medicine, Minneapolis VA Health Care System, Minneapolis, Minnesota.
Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota.
J Endocr Soc. 2019 Nov 29;4(1):bvz027. doi: 10.1210/jendso/bvz027. eCollection 2020 Jan 1.
Incidental detection of thyroid nodules on nonthyroid imaging may contribute to increased diagnosis of thyroid cancer. We investigated the prevalence of thyroid incidentalomas across imaging modalities among a predominately male veteran population.
Thyroid nodules were identified on nonthyroid-directed radiology reports using natural language processing. All reports from 1995 to 2016 for chest computed tomography (CT), carotid ultrasound (US), and neck magnetic resonance imaging (MRI) were reviewed. Individuals with multiple studies were included at their initial study and duplicates removed.
A total of 25 763 carotid US, 23 526 chest CTs with contrast, 39 262 noncontrast chest CTs, and 9503 MRIs were reviewed. With duplicates removed, 14 642 carotid US, 12 923 chest CTs with contrast, 17 416 noncontrast chest CTs, and 6926 MRIs were included. Mean age was 66.2 years and 1834 were female (3.53%). Thyroid nodules were reported on 0.84% carotid US, 3.45% MRIs, 5.84% chest CTs with contrast, and 5.14% noncontrast chest CTs. Women had a higher rate of thyroid nodules on MRI (6.46% vs 3.20%, = .003), chest CT with contrast (9.80% vs 5.72%, = .007), and noncontrast chest CT (8.77% vs 5.02%, = .002), but not on carotid US (1.99% vs 0.81%, = .12). Incidentaloma prevalence increased with age on MRI, chest CT with or without contrast, but not on carotid US, and were more commonly reported from 2007 to 2016 compared to before 2007 across all modalities.
Thyroid incidentalomas are commonly reported, are more common among women, and increase with age. The rate of reported incidental thyroid nodules is increasing, likely contributing to the increase in thyroid cancer.
在非甲状腺成像中偶然发现甲状腺结节可能会增加甲状腺癌的诊断率。我们调查了以男性退伍军人为主的人群中不同成像方式下甲状腺偶发瘤的患病率。
使用自然语言处理技术从非甲状腺定向放射学报告中识别甲状腺结节。回顾了1995年至2016年所有胸部计算机断层扫描（CT）、颈动脉超声（US）和颈部磁共振成像（MRI）的报告。对进行过多次检查的个体，纳入其首次检查结果并去除重复项。
共审查了25763份颈动脉超声、23526份增强胸部CT、39262份非增强胸部CT和9503份MRI报告。去除重复项后，纳入了14642份颈动脉超声、12923份增强胸部CT、17416份非增强胸部CT和6926份MRI报告。平均年龄为66.2岁，女性有1834人（3.53%）。在颈动脉超声中报告甲状腺结节的比例为0.84%，MRI为3.45%，增强胸部CT为5.84%，非增强胸部CT为5.14%。女性在MRI（6.46%对3.20%，P = 0.003）、增强胸部CT（9.80%对5.72%，P = 0.007）和非增强胸部CT（8.77%对5.02%，P = 0.002）上甲状腺结节的发生率较高，但在颈动脉超声上无差异（1.99%对0.81%，P = 0.12）。在MRI、有或无对比剂的胸部CT上，偶发瘤患病率随年龄增加，但在颈动脉超声上无此现象，并且与2007年之前相比，2007年至2016年期间所有成像方式下甲状腺偶发瘤的报告更为常见。
甲状腺偶发瘤报告常见，在女性中更常见，且随年龄增加。报告的甲状腺偶发结节发生率正在上升，可能导致甲状腺癌的增加。
