[The value of ACR-TIRADS and C-TIRADS in the diagnosis of nodular Hashimoto thyroiditis and papillary thyroid carcinoma with Hashimoto thyroiditis].

• DOI: 10.13201/j.issn.2096-7993.2022.06.008
• Publication Date: 2022-06-01
• Authors: Chaoxi Li; Dehui Wen; Haiyong Lu; Yunxuan Chen; Xiangyu Liu
• Keywords: Echogenicity; Thyroid Nodules; Nodule (geology); Overdiagnosis

Objective:To explore the diagnostic value of American Society Radiology Thyroid Imaging Reporting and Data System（ACR-TIRADS） Chinese Nodule Ultrasound Malignant Risk Stratification（C-TIRADS） in nodular Hashimoto thyroiditis papillary thyroid carcinoma with thyroiditis. Methods:This retrospective analysis included 144 patients（204 nodules） accompanied by or under background confirmed surgical pathology examination First Affiliated Hospital Hebei North University from August 2018 to May 2021, all nodules were examined ultrasound, 204 scored graded according classification standards ACR-TIRADS C-TIRADS. The pathological results gold standard. receiver operating characteristic curve C-TIRADS was constructed evaluate compare performance two guideline. Results:①Ultrasound feature showed that Papillary had statistically significant differences location, echogenicity, calcifications margins（P<0.001）, but there is no difference structure aspect ratio between kinds nodular（P=0.141, P=0.240）; mostly absent focal echogenicity hyperechogenicity, while manifested as extrinsic invasion. ②The sensitivity negative predictive 91.7% 83.1%, respectively, which higher than those ACR-TIRADS, significant（P=0.021, P=0.013）; specificity positive T 98.3% 99.2%, both slightly althought not significant（P=0.157, P=0.062）. area 0.806 0.941, significant（P=0.031）. ③The unnecessary FNAB rate 10.3%, lower ACR-TIRADS. Conclusion:C-TI-RADS has a better thyroiditis, helpful for clinical evaluation such nodules.目的：探讨美国放射学会甲状腺影像报告与数据系统（ACR-TIRADS）与中国甲状腺结节超声恶性危险分层（C-TIRADS）对桥本甲状腺炎背景下桥本结节和甲状腺乳头状癌的诊断价值。 方法：回顾性分析2018年8月-2021年5月于河北北方学院附属第一医院行甲状腺超声检查并经手术病理证实的桥本甲状腺炎伴有结节或甲状腺乳头状癌患者141例（204个结节），对所有结节行超声检查，并且按照ACR-TIRADS和C-TIRADS的分类标准对204个结节进行评分分级，以手术病理结果为金标准，构建ACR-TIRADS和C-TIRADS评估桥本结节和甲状腺乳头状癌性质的受试者工作特征曲线，分析和比较二者的诊断效能。 结果：①超声特征结果显示桥本结节和甲状腺乳头状癌在分布位置、回声、钙化和边缘之间的差异有统计学意义（P<0.001），二者在结构和纵横比上差异无统计学意义（P=0.141，P=0.240），桥本结节多表现为无局灶性强回声和高/等回声，甲状腺乳头状癌多表现为局灶性强回声和甲状腺外侵犯；②C-TIRADS诊断桥本结节和甲状腺乳头状癌性质的敏感性和阴性预测值分别为91.7%和83.1%，均高于ACR-TIRADS，差异存在统计学意义（P=0.021，P=0.013）；特异性和阳性预测值分别为98.3%和99.2%，均略高于ACR-TIRADS，差异无统计学意义（P=0.157，P=0.062）。ACR-TIRADS和C-TIRADS两种超声指南的曲线下面积分别为0.806和0.941，差异有统计学意义（P=0.031）；③C-TIRADS超声指南不必要细针抽吸活检率为10.3%，低于ACR-TIRADS。 结论：C-TIRADS对桥本甲状腺炎背景下的桥本结节和甲状腺乳头状癌的诊断具有较高的价值，有助于临床对此类结节的评估。.