To compare the application of different TIRADS in the risk stratification of partially cystic thyroid nodulesShu Liu, Yanjun Liu, Zhuoqun Ma, Yanru, Zhao, Wei Wei* , Bingyin Shi

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To compare the application of different TIRADS in the risk stratification of partially cystic thyroid nodulesShu Liu, Yanjun Liu, Zhuoqun Ma, Yanru, Zhao, Wei Wei* , Bingyin Shi

更新时间：2023-10-11

- To compare the application of different TIRADS in the risk stratification of partially cystic thyroid nodulesShu Liu, Yanjun Liu, Zhuoqun Ma, Yanru, Zhao, Wei Wei* , Bingyin Shi
- Journal of Clinical Ultrasound in Medicine Vol. 25, Issue 3, (2023)
- 作者机构：
  
  1. 西安交通大学第一附属医院内分泌代谢科
  2. 西安交通大学第一附属医院超声医学科
- 作者简介：
- 基金信息：
- DOI：
  CLC：
- Published：2023，
  
  Published Online：6 April 2023，
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To compare the application of different TIRADS in the risk stratification of partially cystic thyroid nodulesShu Liu, Yanjun Liu, Zhuoqun Ma, Yanru, Zhao, Wei Wei* , Bingyin Shi. [J]. Journal of Clinical Ultrasound in Medicine 25(3).(2023)
DOI：

To compare the application of different TIRADS in the risk stratification of partially cystic thyroid nodulesShu Liu, Yanjun Liu, Zhuoqun Ma, Yanru, Zhao, Wei Wei* , Bingyin Shi. [J]. Journal of Clinical Ultrasound in Medicine 25(3).(2023) DOI：

摘要

目的：比较ACR TIRADS、ATA指南及KSThR指南在甲状腺囊实性结节危险分层中的应用。方法：回顾分析本院293例甲状腺囊实性结节的超声影像学特征，比较良恶性结节超声影像学特征及不同TIRADS对甲状腺囊实性结节良恶性的预测价值。结果：46.1%(135/293)的结节接受手术治疗，其中83个为甲状腺乳头状癌（Papillary thyroid cancer，PTC），52个结节为良性；53.9%(158/293)的结节经细胞病理证实为结节性甲状腺肿后未接受手术治疗。比较良恶性结节超声影像学特征，多因素分析结果显示实性部分低回声(OR值：6.684，95%CI：3.158-14.148，P＜0.001)、伴有微钙化(OR值：2.459，95%CI：1.839-3.287，P＜0.001)、边界不规则（OR值：2.587，95%CI：1.068-6.264，P=0.035）结节的恶性风险较高。通过分析ROC曲线下面积，ACR TIRADS分层系统曲线下面积最大，为0.843[95% CI: 0.791-0.895，p＜0.001]，ATA指南次之，为0.797[95% CI: 0.733-0.862，p＜0.001]。KSThR指南最低，为0.785[95% CI: 0.717-0.8524，p＜0.001]。结论：甲状腺囊实性结节伴有实性部分低回声、微钙化、边界不规则时恶性风险较高。ACR TIRADS在甲状腺囊实性结节危险分层方面稍优于ATA及KSThR指南，建议用于临床实践中对甲状腺囊实性结节进行危险分层。

Abstract

Objective: Compared ACR TI-RADS

ATA and KSThR ultrasound classifications performance in predicting high risk of partially cystic nodules Methods: The sonography features from a total of 293 partially cystic thyroid nodules in our hospital were retrospectively analyzed to compare the difference between benign and malignant nodules

and also assess the predictive values of the three TIRADS in identifying high risk of partial cystic thyroid nodules. Results: 46.1% (135/293) nodules underwent surgery

including 83 papillary thyroid cancer (PTC) and 52 benign nodules. 53.9% (158/293) nodular goiter diagnosed by cytology didn’t submit to operation. The sonographic characteristics were analyzed between benign and malignant nodules

the hypoechogenicity of solid portion (OR: 6.684，95%CI：3.158-14.148，P＜0.001)

the presence of microcalcification (OR: 2.459，95%CI：1.839-3.287，P＜0.001) and irregular margin (OR: 2.587，95%CI：1.068-6.264，P=0.035) showed a statistically significant association with malignant nodules by Binary logistic regression analysis. ACR TI-RADS exhibited the highest area under the curve of ROC (0.843

95% CI: 0.791-0.895，p＜0.001)

and that of the ATA and KSThR were 0.797 (95% CI: 0.733-0.862，p＜0.001) and 0.785 (95% CI: 0.717-0.8524，p＜0.001)

respectively. Conclusion: The presence of the hypoechogenicity of solid portion

microcalcification and irregular margin showed high risk of malignancy in partially cystic thyroid nodules. The ACR TIRADS classification system showed slightly more effective in the risk stratification of partially cystic nodules than ATA and KSThR

and was suggested to apply in clinical practice to manage the partially cystic thyroid nodules.

关键词

甲状腺囊实性结节甲状腺乳头状癌TIRADS

Keywords

partially cystic thyroid nodulePapillary thyroid carcinomaTIRADS

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