Dy Joanna Grace, Kasala Ruben, Yao Christy, Ongoco Renncee, Mojica Dondee Jules
Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, The Medical City, Philippines.
Department of Radiology, The Medical City, Philippines.
J ASEAN Fed Endocr Soc. 2017;32(2):108-116. doi: 10.15605/jafes.032.02.03. Epub 2017 Aug 2.
To determine the accuracy of Thyroid Imaging Reporting and Data System (TIRADS) in detecting thyroid malignancy, determine risk of malignancy in each TIRADS category and determine the ultrasound characteristics associated with malignancy.
This is a retrospective cross-sectional study involving patients who underwent ultrasound, thyroid fine needle aspiration biopsy (FNAB) and thyroidectomy at The Medical City from January 2014 to December 2015. Ultrasound reports were retrieved and reviewed by two radiologists on separate occasions who were blinded to the cytopathology and histopathology results. The histopathology reports were correlated with ultrasound features to determine features associated with malignancy. Stata SE 12 was used for data analysis. TIRADS sensitivity, specificity, positive predictive values and negative predictive values and accuracy were calculated.
149 patients with thyroid nodules were included. Solid composition is the ultrasound feature predictive of malignancy with adjusted OR 4.912 (95% Cl 1.3257 to 18.2011, =0.017). The risk of malignancy for TIRADS categories 3, 4a, 4b, 4c and 5 were 12.50%, 12.82%, 26.19%, 53.70% and 66.67%, respectively. The Crude OR (95% CI) for TIRADS 4a, 4b, 4c and 5 were 1.03 (0.10 to 10.23), 2.48 (0.27 to 22.54), 8.12 (0.93 to 70.59) and 14.0 (0.94 to 207.60), respectively. The sensitivity, specificity, PPV, NPV and accuracy of TIRADS in relation to surgical histopathology report were 98.00%, 7.07%, 34.75%, 87.50%, and 53% respectively in TIRADS categories 4 and 5.
This study showed that a solid nodule is the most frequent ultrasound feature predictive of thyroid malignancy. Higher TIRADS classification is associated with higher risk of thyroid malignancy. TIRADS is a sensitive classification in recognizing patients with thyroid cancer.
确定甲状腺影像报告和数据系统（TIRADS）在检测甲状腺恶性肿瘤方面的准确性，确定每个TIRADS分类中的恶性风险，并确定与恶性肿瘤相关的超声特征。
这是一项回顾性横断面研究，涉及2014年1月至2015年12月在医学城接受超声检查、甲状腺细针穿刺活检（FNAB）和甲状腺切除术的患者。超声报告由两位放射科医生在不同时间检索并审查，他们对细胞病理学和组织病理学结果不知情。将组织病理学报告与超声特征相关联，以确定与恶性肿瘤相关的特征。使用Stata SE 12进行数据分析。计算TIRADS的敏感性、特异性、阳性预测值、阴性预测值和准确性。
纳入149例甲状腺结节患者。实性成分是预测恶性肿瘤的超声特征，调整后的OR为4.912（95%CI为1.3257至18.2011，P = 0.017）。TIRADS分类3、4a、4b、4c和5的恶性风险分别为12.50%、12.82%、26.19%、53.70%和66.67%。TIRADS 4a、4b、4c和5的粗OR（95%CI）分别为1.03（0.10至10.23）、2.48（0.27至22.54）、8.12（0.93至70.59）和14.0（0.94至207.60）。在TIRADS分类4和5中，TIRADS相对于手术组织病理学报告的敏感性、特异性、PPV、NPV和准确性分别为98.00%、7.07%、34.75%、87.50%和53%。
本研究表明，实性结节是预测甲状腺恶性肿瘤最常见的超声特征。TIRADS分类越高，甲状腺恶性风险越高。TIRADS在识别甲状腺癌患者方面是一种敏感的分类方法。
