Nabahati Mehrdad, Moazezi Zoleika
Department of Radiology, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran.
Department of Endocrinology, Rohani Hospital, Babol University of Medical Sciences, Babol, Iran.
J Med Ultrasound. 2022 Sep 22;31(2):127-132. doi: 10.4103/jmu.jmu_19_22. eCollection 2023 Apr-Jun.
There is a limited number of studies reporting the performance of European Thyroid Imaging Reporting and Data System (EU-TIRADS) guideline in identifying thyroid nodule malignancy. We aimed to evaluate diagnostic accuracy of EU-TIRADS regardless of thyroid nodule size.
During August 2019-November 2021, subjects with thyroid nodules were prospectively included. Sonographic characteristics were recorded and scored as per EU-TIRADS guideline. Finally, fine-needle aspiration (FNA) was performed, and cytological findings were reported.
Totally, 1266 thyroid nodules from 984 subjects were assessed, of which 295 nodules were smaller than 10 mm and 971 nodules were 10 mm or larger. Among nodules <10 mm, prevalence rates of malignancy for EU-TIRADS classes 2-5 were 0.0%, 3.7%, 20.6%, and 40.9%, respectively; these rates among nodules ≥10 mm were 2.3%, 4.0%, 19.3%, and 43.2%, respectively. The accuracy values of EU-TIRADS class 5 and EU-TIRADS class 4 or 5 in diagnosis of malignancy for nodules <10 mm were 86.4% and 79.7%, respectively; these rates for nodules ≥10 mm were 83.8% and 76.3%, respectively. Hypoechogenicity, microcalcification, ill-defined and irregular margins were predictors for malignancy regardless of thyroid nodule size.
EU-TIRADS could provide an acceptable malignancy risk stratification that is helpful for better distinguishing benignity from malignancy, as well as preventing unnecessary FNA biopsies, in thyroid nodules irrespective of their size.
报告欧洲甲状腺影像报告和数据系统（EU-TIRADS）指南在识别甲状腺结节恶性方面表现的研究数量有限。我们旨在评估EU-TIRADS在不考虑甲状腺结节大小情况下的诊断准确性。
在2019年8月至2021年11月期间，前瞻性纳入患有甲状腺结节的受试者。记录超声特征并根据EU-TIRADS指南进行评分。最后，进行细针穿刺（FNA）并报告细胞学结果。
总共评估了984名受试者的1266个甲状腺结节，其中295个结节小于10毫米，971个结节为10毫米或更大。在小于10毫米的结节中，EU-TIRADS 2-5类的恶性患病率分别为0.0%、3.7%、20.6%和40.9%；在大于等于10毫米的结节中，这些患病率分别为2.3%、4.0%、19.3%和43.2%。对于小于10毫米的结节，EU-TIRADS 5类和EU-TIRADS 4或5类在诊断恶性方面的准确性值分别为86.4%和79.7%；对于大于等于10毫米的结节，这些值分别为83.8%和76.3%。无论甲状腺结节大小如何，低回声、微钙化、边界不清和不规则边缘都是恶性的预测因素。
EU-TIRADS可以提供可接受的恶性风险分层，有助于更好地区分甲状腺结节的良性与恶性，以及避免不必要的FNA活检，无论结节大小如何。
