Department of Ultrasound, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang, China (mainland).
College of Life Science and Medicine, Zhejiang Sci-Tech University, Hangzhou, Zhejiang, China (mainland).
Med Sci Monit. 2024 May 20;30:e943228. doi: 10.12659/MSM.943228.
BACKGROUND Thyroid nodule prevalence reaches 65% in the general population. Hence, appropriate ultrasonic examination is key in disease monitoring and management. We investigated the American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) score for diagnosis of benign and malignant thyroid nodules and pathological types. MATERIAL AND METHODS A retrospective study was conducted. According to ultrasound images, ultrasonic characteristics of benign and malignant thyroid nodules and different pathological types were analyzed using ACR-TIRADS score, and diagnostic value was determined. AUCs were compared for tumor diagnosis and differentiation. RESULTS Overall, 1675 thyroid nodules from 1614 patients were included. AUC value of papillary thyroid carcinoma (PTC) diagnosed with ACR-TIRADS was highest (0.955 [95% CI=0.946-0.965]), while that of follicular thyroid carcinoma (FTC) was lowest (0.877 [95% CI=0.843-0.912]). FTC had the highest sensitivity (95.1%) and lowest specificity (64.8%). When the cut-off value was 5.5 points, accuracy of diagnosing PTC and anaplastic thyroid carcinoma (ATC) was highest, 80.5% and 78.7% respectively. Comparison of the multi-index prediction model constructed by multivariable logistic regression analysis and prediction model constructed by ACR-TIRADS score showed, when evaluating PTC and ATC, the multi-index model was better: AUCs of PTC were 0.966 vs 0.955, and AUCs of ATC were 0.982 vs 0.952, respectively, (P<0.05). CONCLUSIONS ACR-TIRADS score-based ultrasound examination of thyroid nodules aids diagnosis of benign and malignant thyroid nodules. TIRADS criteria favor diagnosis of PTC (and ATC) over FTC. ACR-TIRADS score can help clinicians diagnose thyroid nodules quickly and earlier, exhibits good clinical value, and can prevent missed diagnoses.
甲状腺结节在普通人群中的患病率达到 65%。因此，适当的超声检查是疾病监测和管理的关键。我们研究了美国放射学院甲状腺成像报告和数据系统（ACR-TIRADS）评分在诊断良性和恶性甲状腺结节及病理类型中的作用。
回顾性研究。根据超声图像，分析良性和恶性甲状腺结节及不同病理类型的超声特征，采用 ACR-TIRADS 评分进行诊断，并确定诊断价值。比较 AUC 用于肿瘤诊断和鉴别。
共纳入 1614 例患者的 1675 个甲状腺结节。ACR-TIRADS 诊断甲状腺乳头状癌（PTC）的 AUC 值最高（0.955 [95%CI=0.946-0.965]），滤泡状甲状腺癌（FTC）最低（0.877 [95%CI=0.843-0.912]）。FTC 的敏感性最高（95.1%），特异性最低（64.8%）。当截断值为 5.5 分时，PTC 和间变性甲状腺癌（ATC）的诊断准确率最高，分别为 80.5%和 78.7%。多变量逻辑回归分析构建的多指标预测模型与 ACR-TIRADS 评分构建的预测模型比较显示，评估 PTC 和 ATC 时，多指标模型更好：PTC 的 AUC 分别为 0.966 与 0.955，ATC 的 AUC 分别为 0.982 与 0.952，（P<0.05）。
基于 ACR-TIRADS 评分的甲状腺结节超声检查有助于诊断良性和恶性甲状腺结节。TIRADS 标准有利于诊断 PTC（和 ATC）而非 FTC。ACR-TIRADS 评分有助于临床医生快速和更早地诊断甲状腺结节，具有良好的临床价值，并可防止漏诊。
