Thyroid Imaging Reporting and Data System for US Features of Nodules : A Step in Establishing Better Stratification of Cancer Risk
Thyroid Imaging Reporting and Data System for US Features of Nodules : A Step in Establishing Better Stratification of Cancer Risk
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DOI：
10.1148/radiol.11110206
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发表时间：
2011-09-01
期刊：
影响因子：
19.7
通讯作者：
Kim, Eun-Kyung
中科院分区：
文献类型：
--
作者：
Kwak, Jin Young;Han, Kyung Hwa;Kim, Eun-Kyung
目的：开发一个实用的甲状腺成像报告和数据系统（TIRADS），与甲状腺结节分类和分层其恶性risk.Materials和方法：机构审查委员会批准了这项回顾性研究，并要求获得知情同意的图像和记录的审查被免除。从2008年5月至12月，超声（US）引导下细针穿刺活检（FNAB）在3414例连续患者的3674个局灶性甲状腺结节中进行。该研究包括1638名患者（1373名女性，265名男性）的1658个甲状腺结节（US最大直径>= 1 cm），这些患者的病理诊断或随访结果可用。采用广义估计方程进行单因素和多因素分析，以探讨可疑超声特征与甲状腺癌的关系。对每个显著因素进行评分，并乘以从多变量逻辑回归分析中获得的每个显著因素的β系数。然后将每个重要因素的得分相加，得到一个适合甲状腺结节恶性概率的方程。作者评估了拟合的概率，通过使用回归方程;恶性肿瘤的风险是根据可疑的US features.Results的数量确定的：以下US功能表现出了显着的关联与恶性肿瘤：实性成分，低回声，显着低回声，微分叶状或不规则的边缘，微钙化，和taller-than-wide形状。随着可疑US特征数量的增加，恶性肿瘤的拟合概率和风险也增加。根据可疑US特征的数量，阳性预测值有显著差异（P <0.001）。结论：使用可疑US特征的数量进行甲状腺恶性肿瘤的危险分层，可以实现实用和方便的TIRADS。(C)RSNA，2011年
Purpose: To develop a practical thyroid imaging reporting and data system (TIRADS) with which to categorize thyroid nodules and stratify their malignant risk.Materials and Methods: The institutional review board approved this retrospective study, and the requirement to obtain informed consent for the review of images and records was waived. From May to December 2008, ultrasonographically (US)-guided fine-needle aspiration biopsy (FNAB) was performed in 3674 focal thyroid nodules in 3414 consecutive patients. The study included the 1658 thyroid nodules (>= 1 cm in maximum diameter at US) in 1638 patients (1373 women, 265 men) for which pathologic diagnosis or follow-up findings were available. Univariate and multivariate analyses with generalized estimating equations were performed to investigate the relationship between suspicious US features and thyroid cancer. A score for each significant factor was assigned and multiplied by the beta coefficient obtained for each significant factor from multivariate logistic regression analysis. Scores for each significant factor were then added, resulting in an equation that fitted the probability of malignancy in thyroid nodules. The authors evaluated the fitted probability by using a regression equation; the risk of malignancy was determined according to the number of suspicious US features.Results: The following US features showed a significant association with malignancy: solid component, hypoechogenicity, marked hypoechogenicity, microlobulated or irregular margins, microcalcifications, and taller-than-wide shape. As the number of suspicious US features increased, the fitted probability and risk of malignancy also increased. Positive predictive values according to the number of suspicious US features were significantly different (P < .001).Conclusion: Risk stratification of thyroid malignancy by using the number of suspicious US features allows for a practical and convenient TIRADS. (C) RSNA, 2011