Comparison of the diagnostic performance of three ultrasound thyroid nodule risk stratification systems for follicular thyroid neoplasm: K-TIRADS, ACR -TIRADS and C-TIRADS.

IF 2.1 4区医学 Q3 HEMATOLOGY Clinical hemorheology and microcirculation Pub Date : 2023-01-01 DOI:10.3233/CH-231898

Hua-Juan Li, Yu-Ping Yang, Xin Liang, Zhi Zhang, Xiao-Hong Xu

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Abstract

Objective: To explore the diagnostic performance of the currently used ultrasound-based thyroid nodule risk stratification systems (K-TIRADS, ACR -TIRADS, and C-TIRADS) in differentiating follicular thyroid adenoma (FTA) from follicular thyroid carcinoma (FTC).

Methods: Clinical data and preoperative ultrasonographic images of 269 follicular thyroid neoplasms were retrospectively analyzed. All of them were detected by Color Doppler ultrasound instruments equipped with high-frequency liner array probes (e.g. Toshiba Apoli500 with L5-14MHZ; Philips IU22 with L5-12MHZ; GE LOGIQ E9 with L9-12MHZ and MyLab Class C with L9-14MHZ). The diagnostic performance of three TIRADS classifications for differentiating FTA from FTC was evaluated by drawing the receiver operating characteristic (ROC) curves and calculating the cut-off values.

Results: Of the 269 follicular neoplasms (mean size, 3.67±1.53 cm), 209 were FTAs (mean size, 3.56±1.38 cm) and 60 were FTCs (mean size, 4.07±1.93 cm). There were significant differences in ultrasound features such as margins, calcifications, and vascularity of thyroid nodules between the FTA and FTC groups (P < 0.05). According to the ROC curve comparison analysis, the diagnostic cut-off values of K-TIRADS, ACR-TIRADS, and C-TIRADS for identifying FTA and FTC were K-TR4, ACR-TR4, and C-TR4B, respectively, and the areas under the curves were 0.676, 0.728, and 0.719, respectively. The difference between ACR-TIRADS and K-TIRADS classification was statistically significant (P = 0.0241), whereas the differences between ACR-TIRADS and C-TIRADS classification and between K-TIRADS and C-TIRADS classification were not statistically significant (P > 0.05).

Conclusion: The three TIRADS classifications were not conducive to distinguishing FTA from FTC. It is necessary to develop a novel malignant risk stratification system specifically for the identification of follicular thyroid neoplasms.

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K-TIRADS、ACR -TIRADS和C-TIRADS三种甲状腺超声结节甲状腺滤泡性肿瘤风险分层系统的诊断性能比较。

目的探讨目前使用的基于超声的甲状腺结节风险分层系统（K-TIRADS、ACR -TIRADS和C-TIRADS）在区分甲状腺滤泡腺瘤（FTA）和甲状腺滤泡癌（FTC）方面的诊断性能：回顾性分析了269例甲状腺滤泡性肿瘤的临床数据和术前超声图像。所有甲状腺滤泡性肿瘤均由配备高频衬垫阵列探头的彩色多普勒超声仪器（如东芝 Apoli500，L5-14MHZ；飞利浦 IU22，L5-12MHZ；通用电气 LOGIQ E9，L9-12MHZ 和 MyLab Class C，L9-14MHZ）检测。通过绘制接收器操作特征曲线（ROC）和计算临界值，评估了三种 TIRADS 分类在区分 FTA 和 FTC 方面的诊断性能：在 269 例卵泡肿瘤（平均大小为 3.67±1.53 厘米）中，209 例为 FTA（平均大小为 3.56±1.38 厘米），60 例为 FTC（平均大小为 4.07±1.93 厘米）。FTA组和FTC组甲状腺结节的边缘、钙化和血管等超声特征有明显差异（P 0.05）：结论：TIRADS的三种分类不利于区分FTA和FTC。有必要开发一种新的恶性风险分层系统，专门用于鉴别滤泡性甲状腺肿瘤。

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来源期刊

Clinical hemorheology and microcirculation 医学-外周血管病

CiteScore

4.30

自引率

33.30%

发文量

170

期刊介绍： Clinical Hemorheology and Microcirculation, a peer-reviewed international scientific journal, serves as an aid to understanding the flow properties of blood and the relationship to normal and abnormal physiology. The rapidly expanding science of hemorheology concerns blood, its components and the blood vessels with which blood interacts. It includes perihemorheology, i.e., the rheology of fluid and structures in the perivascular and interstitial spaces as well as the lymphatic system. The clinical aspects include pathogenesis, symptomatology and diagnostic methods, and the fields of prophylaxis and therapy in all branches of medicine and surgery, pharmacology and drug research. The endeavour of the Editors-in-Chief and publishers of Clinical Hemorheology and Microcirculation is to bring together contributions from those working in various fields related to blood flow all over the world. The editors of Clinical Hemorheology and Microcirculation are from those countries in Europe, Asia, Australia and America where appreciable work in clinical hemorheology and microcirculation is being carried out. Each editor takes responsibility to decide on the acceptance of a manuscript. He is required to have the manuscript appraised by two referees and may be one of them himself. The executive editorial office, to which the manuscripts have been submitted, is responsible for rapid handling of the reviewing process. Clinical Hemorheology and Microcirculation accepts original papers, brief communications, mini-reports and letters to the Editors-in-Chief. Review articles, providing general views and new insights into related subjects, are regularly invited by the Editors-in-Chief. Proceedings of international and national conferences on clinical hemorheology (in original form or as abstracts) complete the range of editorial features.