Botha Mariska, Kisansa Margaret, Greeff Wim
Department of Health, Faculty of Radiology, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
SA J Radiol. 2020 Feb 6;24(1):1804. doi: 10.4102/sajr.v24i1.1804. eCollection 2020.
Thyroid nodules are common, the majority benign. The small risk of malignancy leads to excessive workup. Thyroid ultrasound is essential for risk stratification and management guidance. Without an organised reporting guideline, reports do not add significant value to referring clinicians. The American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) was developed to aid ultrasound reporting, lessen excessive biopsies and diagnose thyroid cancers.
To standardise reporting of thyroid ultrasounds by utilising an organised reporting guideline based on ACR TI-RADS.
Thyroid ultrasound reports generated by radiology registrars at an academic hospital were studied in two phases. In Phase 1, the reports were generated as free text, and in Phase 2, using a guideline based on ACR TI-RADS. The percentages of reports that described the maximum size, the five ACR TI-RADS features and a management recommendation were compared.
A total of 130 reports were studied. Significant improvement was observed in the description of all five ACR TI-RADS categories ( < 0.0001) from Phase 1 to Phase 2. Of all the reports, 89% included a management recommendation. Reports including an ACR TI-RADS-based recommendation increased from 48% to 75% ( < 0.05). Recommendation for biopsy increased from 35.4% to 53.8% ( < 0.05).
Introduction of an organised reporting guideline based on ACR TI-RADS, standardised reporting of thyroid ultrasounds by increasing description of thyroid nodule features and ensuring appropriate management recommendations. This, in future, will prevent underdiagnosis of thyroid cancer and unnecessary workup of benign nodules.
甲状腺结节很常见，大多数为良性。恶性风险虽小，但却导致了过度检查。甲状腺超声对于风险分层和管理指导至关重要。如果没有一个有条理的报告指南，报告对转诊临床医生而言并无显著价值。美国放射学会甲状腺影像报告和数据系统（ACR TI-RADS）旨在辅助超声报告，减少过度活检并诊断甲状腺癌。
通过采用基于ACR TI-RADS的有条理的报告指南来规范甲状腺超声报告。
对一家学术医院放射科住院医师生成的甲状腺超声报告分两个阶段进行研究。在第一阶段，报告以自由文本形式生成；在第二阶段，使用基于ACR TI-RADS的指南。比较了描述最大尺寸、ACR TI-RADS的五个特征以及管理建议的报告百分比。
共研究了130份报告。从第一阶段到第二阶段，在ACR TI-RADS所有五个类别中的描述均有显著改善（<0.0001）。在所有报告中，89%包含管理建议。包含基于ACR TI-RADS建议的报告从48%增至75%（<0.05）。活检建议从35.4%增至53.8%（<0.05）。
引入基于ACR TI-RADS的有条理的报告指南，通过增加对甲状腺结节特征的描述并确保适当的管理建议，规范了甲状腺超声报告。这在未来将防止甲状腺癌的漏诊以及对良性结节的不必要检查。
