The clinical significance and burden of thyroid nodules discovered incidentally.

IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Irish Journal of Medical Science Pub Date : 2024-12-26 DOI:10.1007/s11845-024-03858-4
Rohil F Dureja, Caoimhe Casey, Josephine Barry, Antoinette Tuthill
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Abstract

Background: The majority of thyroid nodules are benign; however current guidelines suggest that thyroid incidentalomas should be appropriately evaluated to rule out malignancy.

Aims: This study aims to determine the incidence of thyroid incidentalomas and the likelihood that they harbour sinister pathology in the largest Irish cohort studied to-date.

Methods: A retrospective observational chart review was conducted using data from July 2018 to December 2018 using the Radiology Database in use at Cork University Hospital. The text of 1000 imaging reports (500 carotid Doppler and 500 computed tomography thorax) was manually screened for phrases such as "thyroid mass" or "thyroid nodule".

Results: On 1000 scans, 14 (1.4%) thyroid incidentalomas were discovered. The occurrence of incidentalomas by imaging was 2/500 (0.4%) for ultrasound and 12/500 (2.4%) for computed tomography. Three of these nodules (21.4%) were further evaluated with a subsequent ultrasound and due to a size of more than 1 cm underwent fine needle aspiration. Using the Thy classification, all three were given a Thy 2 (non-neoplastic) grading.

Conclusion: This study found that there was no clinical benefit to reporting the presence of thyroid incidentalomas incidentally noted on radiology investigations. Although the overall percentage of thyroid incidentalomas is low, this number may be enough to cause unnecessary strain on the healthcare system and burden patients with invasive investigations in addition to causing unnecessary anxiety.

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偶然发现的甲状腺结节的临床意义和负担。
背景:大多数甲状腺结节是良性的;然而,目前的指南建议应适当评估甲状腺偶发瘤以排除恶性肿瘤。目的:本研究旨在确定甲状腺偶发瘤的发生率,以及迄今为止爱尔兰最大队列研究中甲状腺偶发瘤潜藏险恶病理的可能性。方法:利用科克大学医院使用的放射学数据库,对2018年7月至2018年12月的数据进行回顾性观察图回顾。1000份影像学报告(500份颈动脉多普勒和500份胸部计算机断层扫描)的文本被人工筛选为“甲状腺肿块”或“甲状腺结节”等短语。结果:在1000次扫描中,发现14例(1.4%)甲状腺偶发瘤。超声检查偶发瘤的发生率为2/500(0.4%),计算机断层检查为12/500(2.4%)。其中3个结节(21.4%)在随后的超声检查中进一步评估,由于大小超过1cm,进行了细针穿刺。采用Thy分级,所有3例均给予th2(非肿瘤性)分级。结论:本研究发现,报告偶然在放射学调查中发现的甲状腺偶发瘤的存在并没有临床益处。虽然甲状腺偶发瘤的总体百分比很低,但这一数字可能足以对医疗系统造成不必要的压力,除了引起不必要的焦虑外,还会给患者带来侵入性检查的负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Irish Journal of Medical Science
Irish Journal of Medical Science 医学-医学:内科
CiteScore
3.70
自引率
4.80%
发文量
357
审稿时长
4-8 weeks
期刊介绍: The Irish Journal of Medical Science is the official organ of the Royal Academy of Medicine in Ireland. Established in 1832, this quarterly journal is a contribution to medical science and an ideal forum for the younger medical/scientific professional to enter world literature and an ideal launching platform now, as in the past, for many a young research worker. The primary role of both the Academy and IJMS is that of providing a forum for the exchange of scientific information and to promote academic discussion, so essential to scientific progress.
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