美国放射学会TI-RADS在甲状腺癌中的应用价值

Diagnostic value of ACR TI-RADS in thyroid carcinoma

目的:探讨美国放射学会(American College of Radiology,ACR)甲状腺影像报告与数据系统(Thyroid Imaging Reporting and Data System,TI-RADS)分类在甲状腺癌诊断中的应用价值。方法:选取2015年6月—2017年6月于上海交通大学医学院附属同仁医院行甲状腺手术治疗且手术后病理学检查结果为甲状腺癌的104例患者,共123个结节,进行回顾性分析,根据ACR的TI-RADS分类标准分析甲状腺癌的二维超声声像图特征。结果:123个结节均表现为实性结节(100%),结节呈低回声或极低回声(100%)。其余特征性指标为垂直位生长(72.36%)、结节内部点状强回声(54.47%)、结节分叶状或形态不规则(37.40%)及结节向甲状腺外侵犯(17.89%)。113个TR5甲状腺癌中,出现颈部淋巴结转移31个,淋巴结转移发生率与甲状腺结节大小无相关性。结论:2017版ACR的TI-RADS运用了定量评分来评估甲状腺结节,检出甲状腺癌的灵敏度高,操作简便易掌握,但对TR4和TR5结节的处理建议中,以大小为标准区分可能过于保守和简单。

Objective: To evaluate the diagnostic value of American College of Radiology(ACR) Thyroid Imaging Reporting and Data System(TI-RADS) in thyroid carcinoma. Methods: The sonographic features of 123 thyroid carcinoma nodules of confirmed by surgical pathology were retrospectively analyzed using ACR TI-RADS. Results: All thyroid carcinoma nodules were solid or almost completely solid(100%), hypoechoic or extremely hypoechoic(100%), and the other sonographic features were vertical growth(72.36%), punctuate echogenic foci(54.47%), lobulated/irregular shape(37.40%) and extra-thyroidal extension(17.89%).In 113 TR5 nodules, 31 had cervical lymph node metastasis. The correlation between lymph node metastasis rate and thyroid nodule size was not statistically significant. Conclusion: The 2017 ACR TI-RADS employs quantitative score in the assessment of thyroid nodules, with high sensitivity in the detection of thyroid carcinoma, and it is easy to handle. However, it is probably conservative and simple to distinguish nodules by size in TR4 and TR5 nodules.