甲状腺结节的风险分层：从超声特征到甲状腺影像报告和数据系统（TIRADS）
Risk Stratification of Thyroid Nodules: From Ultrasound Features to TIRADS.
作者信息
Rago Teresa, Vitti Paolo
机构信息
Department of Clinical and Experimental Medicine, Endocrinology Section, University of Pisa, 56124 Pisa, Italy.
出版信息
Cancers (Basel). 2022 Jan 30;14(3):717. doi: 10.3390/cancers14030717.
Abstract
Thyroid nodules are common in iodine deficient areas, in females, and in patients undergoing neck irradiation. High-resolution ultrasonography (US) is important for detecting and evaluating thyroid nodules. US is used to determine the size and features of thyroid nodules, as well as the presence of neck lymph node metastasis. It also facilitates guided fine-needle aspiration (US-FNA). The most consistent US malignancy features of thyroid nodules are spiculated margins, microcalcifications, a taller-than-wide shape, and marked hypoechogenicity. Increased nodular vascularization is not identified as a predictor of malignancy. Thyroid elastosonography (USE) is also used to characterize thyroid nodules. In fact, a low elasticity of nodules at USE has been related to a higher risk of malignancy. According to their US features, thyroid nodules can be stratified into three categories: low-, intermediate-, and high-risk nodules. US-FNA is suggested for intermediate and high-risk nodules.
摘要
甲状腺结节在碘缺乏地区、女性以及接受颈部放疗的患者中很常见。高分辨率超声（US）对于检测和评估甲状腺结节很重要。US用于确定甲状腺结节的大小和特征，以及颈部淋巴结转移的情况。它还便于引导细针穿刺活检（US-FNA）。甲状腺结节最一致的US恶性特征是边缘呈毛刺状、微钙化、纵横比大于1以及显著低回声。结节血管增多未被视为恶性的预测指标。甲状腺弹性成像（USE）也用于对甲状腺结节进行特征描述。事实上，USE显示结节弹性低与较高的恶性风险相关。根据其US特征，甲状腺结节可分为三类：低风险、中风险和高风险结节。建议对中风险和高风险结节进行US-FNA。
相似文献
1
Risk Stratification of Thyroid Nodules: From Ultrasound Features to TIRADS.甲状腺结节的风险分层：从超声特征到甲状腺影像报告和数据系统（TIRADS）
Cancers (Basel). 2022 Jan 30;14(3):717. doi: 10.3390/cancers14030717.
2
Non-Marked Hypoechogenic Nodules: Multicenter Study on the Thyroid Malignancy Risk Stratification and Accuracy Based on TIRADS Systems Comparison.非典型低回声结节：基于 TIRADS 系统比较的甲状腺恶性肿瘤风险分层和准确性的多中心研究。
Medicina (Kaunas). 2022 Feb 9;58(2):257. doi: 10.3390/medicina58020257.
3
Malignancy risk stratification in thyroid nodules with nondiagnostic results at cytologic examination: combination of thyroid imaging reporting and data system and the Bethesda System.甲状腺细针穿刺细胞学检查结果不明确的甲状腺结节恶性风险分层：甲状腺影像报告和数据系统与 Bethesda 系统的联合应用。
Radiology. 2015 Jan;274(1):287-95. doi: 10.1148/radiol.14140359. Epub 2014 Aug 18.
4
Thyroid ultrasound features and risk of carcinoma: a systematic review and meta-analysis of observational studies.甲状腺超声特征与癌风险：观察性研究的系统评价和荟萃分析
Thyroid. 2015 May;25(5):538-50. doi: 10.1089/thy.2014.0353. Epub 2015 Mar 31.
5
Cytology-Ultrasonography Risk-Stratification Scoring System Based on Fine-Needle Aspiration Cytology and the Korean-Thyroid Imaging Reporting and Data System.基于细针抽吸细胞学和韩国甲状腺影像报告和数据系统的细胞学-超声风险分层评分系统。
Thyroid. 2017 Jul;27(7):953-959. doi: 10.1089/thy.2016.0603. Epub 2017 May 19.
6
Large (≥3cm) thyroid nodules with benign cytology: Can Thyroid Imaging Reporting and Data System (TIRADS) help predict false-negative cytology?细胞学检查为良性的大（≥3cm）甲状腺结节：甲状腺影像报告和数据系统（TIRADS）能否有助于预测细胞学假阴性结果？
PLoS One. 2017 Oct 12;12(10):e0186242. doi: 10.1371/journal.pone.0186242. eCollection 2017.
7
Malignancy risk stratification in thyroid nodules with benign results on cytology: combination of thyroid imaging reporting and data system and Bethesda system.甲状腺结节细胞学检查结果为良性时的恶性风险分层：甲状腺影像报告和数据系统与贝塞斯达系统的联合应用
Ann Surg Oncol. 2014 Jun;21(6):1898-903. doi: 10.1245/s10434-014-3556-2. Epub 2014 Feb 21.
8
Thyroid Imaging Reporting and Data System Risk Stratification of Thyroid Nodules: Categorization Based on Solidity and Echogenicity.甲状腺影像报告和数据系统对甲状腺结节的风险分层：基于实性和回声性的分类
Thyroid. 2016 Apr;26(4):562-72. doi: 10.1089/thy.2015.0460. Epub 2016 Feb 9.
9
Diagnostic Performance of Ultrasound Patterns by K-TIRADS and 2015 ATA Guidelines in Risk Stratification of Thyroid Nodules and Follicular Lesions of Undetermined Significance.超声 K-TIRADS 分类与 2015 年 ATA 指南在甲状腺结节及滤泡性肿瘤良恶性危险分层中的诊断效能
AJR Am J Roentgenol. 2019 Aug;213(2):444-450. doi: 10.2214/AJR.18.20961. Epub 2019 Apr 30.
10
Impact of the Hypoechogenicity Criteria on Thyroid Nodule Malignancy Risk Stratification Performance by Different TIRADS Systems.不同甲状腺影像报告和数据系统（TIRADS）中低回声标准对甲状腺结节恶性风险分层性能的影响
Cancers (Basel). 2021 Nov 8;13(21):5581. doi: 10.3390/cancers13215581.
引用本文的文献
1
Multimodal radiomics model with triple -timepoint contrast-enhanced ultrasound for precise diagnosis of C-TIRADS 4 thyroid nodules.用于精准诊断C-TIRADS 4类甲状腺结节的多模态影像组学模型与三时间点对比增强超声
Front Endocrinol (Lausanne). 2025 Aug 19;16:1639017. doi: 10.3389/fendo.2025.1639017. eCollection 2025.
2
XGBoost-based machine learning model combining clinical and ultrasound data for personalized prediction of thyroid nodule malignancy.基于XGBoost的机器学习模型结合临床和超声数据用于甲状腺结节恶性肿瘤的个性化预测
Front Endocrinol (Lausanne). 2025 Jul 29;16:1639639. doi: 10.3389/fendo.2025.1639639. eCollection 2025.
3
Construction of a predictive model for cervical lymph node metastasis in papillary thyroid carcinoma.乳头状甲状腺癌颈淋巴结转移预测模型的构建
Front Oncol. 2025 May 15;15:1549148. doi: 10.3389/fonc.2025.1549148. eCollection 2025.
4
Correlation of multiple peripheral blood parameters with metastasis and invasion of papillary thyroid cancer: a retrospective cohort study.多种外周血参数与甲状腺乳头状癌转移和侵袭的相关性：一项回顾性队列研究
Endocrine. 2025 Jun;88(3):757-765. doi: 10.1007/s12020-025-04194-y. Epub 2025 Mar 1.
5
The accuracy of fine-needle aspiration cytology and ultrasonography in assessing thyroid nodules in correlation with histopathology: a retrospective study.细针穿刺细胞学检查和超声检查在评估甲状腺结节与组织病理学相关性方面的准确性：一项回顾性研究。
Ann Med Surg (Lond). 2024 Oct 23;86(12):7002-7009. doi: 10.1097/MS9.0000000000002676. eCollection 2024 Dec.
6
Histopathological Analysis of Thyroid Nodules with Taller-Than-Wide Shape in Adults.成人中高大于宽型甲状腺结节的组织病理学分析
Int J Gen Med. 2024 Nov 7;17:5123-5131. doi: 10.2147/IJGM.S473731. eCollection 2024.
7
Diagnostic Nomogram Model for ACR TI-RADS 4 Nodules Based on Clinical, Biochemical Data and Sonographic Patterns.基于临床、生化数据及超声特征的ACR TI-RADS 4类结节诊断列线图模型
Clin Endocrinol (Oxf). 2025 Jan;102(1):79-90. doi: 10.1111/cen.15130. Epub 2024 Sep 16.
8
Correlation analysis between BRAF mutation and ultrasonic and clinical features of papillary thyroid cancer.BRAF突变与甲状腺乳头状癌超声及临床特征的相关性分析
Heliyon. 2024 Apr 25;10(9):e29955. doi: 10.1016/j.heliyon.2024.e29955. eCollection 2024 May 15.
9
Predicting central cervical lymph node metastasis in papillary thyroid carcinoma with Hashimoto's thyroiditis: a practical nomogram based on retrospective study.预测合并桥本甲状腺炎的乳头状甲状腺癌中央区颈淋巴结转移：基于回顾性研究的实用列线图
PeerJ. 2024 Apr 19;12:e17108. doi: 10.7717/peerj.17108. eCollection 2024.
10
Head-to-head comparison of American, European, and Asian TIRADSs in thyroid nodule assessment: systematic review and meta-analysis.头对头比较美国、欧洲和亚洲 TIRADS 在甲状腺结节评估中的应用：系统评价和荟萃分析。
Eur Thyroid J. 2024 Mar 15;13(2). doi: 10.1530/ETJ-23-0242. Print 2024 Apr 1.
本文引用的文献
1
2021 Korean Thyroid Imaging Reporting and Data System and Imaging-Based Management of Thyroid Nodules: Korean Society of Thyroid Radiology Consensus Statement and Recommendations.2021 年韩国甲状腺影像报告和数据系统及基于影像学的甲状腺结节管理：韩国甲状腺放射学会共识声明和建议。
Korean J Radiol. 2021 Dec;22(12):2094-2123. doi: 10.3348/kjr.2021.0713. Epub 2021 Oct 26.
2
The role of multimodal ultrasonic flow imaging in Thyroid Imaging Reporting and Data System (TI-RADS) 4 nodules.多模态超声血流成像在甲状腺影像报告和数据系统（TI-RADS）4类结节中的作用
Gland Surg. 2020 Oct;9(5):1469-1477. doi: 10.21037/gs-20-641.
3
2020 Chinese guidelines for ultrasound malignancy risk stratification of thyroid nodules: the C-TIRADS.2020年中国甲状腺结节超声恶性风险分层指南：C-TIRADS
Endocrine. 2020 Nov;70(2):256-279. doi: 10.1007/s12020-020-02441-y. Epub 2020 Aug 21.
4
Performance of EU-TIRADS in malignancy risk stratification of thyroid nodules: a meta-analysis.EU-TIRADS 在甲状腺结节恶性风险分层中的表现：一项荟萃分析。
Eur J Endocrinol. 2020 Sep;183(3):255-264. doi: 10.1530/EJE-20-0204.
5
Diagnostic Performance of Neck Ultrasonography in the Preoperative Evaluation for Extrathyroidal Extension of Suspicious Thyroid Nodules.超声检查在可疑甲状腺结节甲状腺外侵犯术前评估中的诊断性能。
World J Surg. 2020 Aug;44(8):2669-2674. doi: 10.1007/s00268-020-05482-6.
6
Performance of contrast-enhanced ultrasound (CEUS) in assessing thyroid nodules: a systematic review and meta-analysis using histological standard of reference.超声造影（CEUS）在评估甲状腺结节中的性能：以组织学标准为参照的系统评价和荟萃分析。
Radiol Med. 2020 Apr;125(4):406-415. doi: 10.1007/s11547-019-01129-2. Epub 2020 Jan 22.
7
Assessment of American College of Radiology Thyroid Imaging Reporting and Data System (TI-RADS) for Pediatric Thyroid Nodules.美国放射学院甲状腺影像报告和数据系统（TI-RADS）在儿科甲状腺结节评估中的应用。
Radiology. 2020 Feb;294(2):415-420. doi: 10.1148/radiol.2019191326. Epub 2019 Dec 10.
8
Vascular flow on doppler sonography may not be a valid characteristic to distinguish colloid nodules from papillary thyroid carcinoma even when accounting for nodular size.即使考虑到结节大小，多普勒超声检查中的血管血流情况也可能不是区分胶体结节和甲状腺乳头状癌的有效特征。
Gland Surg. 2019 Oct;8(5):461-468. doi: 10.21037/gs.2019.08.06.
9
Performance of Five Ultrasound Risk Stratification Systems in Selecting Thyroid Nodules for FNA.五种超声风险分层系统在甲状腺结节细针抽吸活检中的应用性能。
J Clin Endocrinol Metab. 2020 May 1;105(5). doi: 10.1210/clinem/dgz170.
10
Thyroid ultrasonography reporting: consensus of Italian Thyroid Association (AIT), Italian Society of Endocrinology (SIE), Italian Society of Ultrasonography in Medicine and Biology (SIUMB) and Ultrasound Chapter of Italian Society of Medical Radiology (SIRM).甲状腺超声报告：意大利甲状腺协会（AIT）、意大利内分泌学会（SIE）、意大利医学超声生物学学会（SIUMB）和意大利医学放射学会超声分会（SIRM）的共识。
J Endocrinol Invest. 2018 Dec;41(12):1435-1443. doi: 10.1007/s40618-018-0935-8. Epub 2018 Oct 16.
Zotero 插件