美国放射学学院甲状腺成像报告和数据系统的评估和应用,以改善儿童甲状腺结节中恶性瘤的检测
Carlos A Ortega1, Jean-Nicolas Gallant2, Irem Kilic3
1School of Medicine, Vanderbilt University, Nashville, Tennessee, USA.
概括
美国放射学学院甲状腺成像报告和数据系统 (TI-RADS) 要求对儿科甲状腺结节进行修改. 量身定制的指导方针显著降低了儿童遗漏癌症的风险.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
背景情况:
- 美国放射学学院甲状腺成像报告和数据系统 (TI-RADS) 是成人甲状腺结节的标准.
- 它在儿科患者中的应用是有争议的,因为它有可能延迟癌症诊断.
研究的目的:
- 评估小儿甲状腺结节中的TI-RADS性能.
- 为了适应细针吸收活检 (FNAB) 对儿童的建议.
主要方法:
- 对手术切除的儿科甲状腺结节 (2003-2021) 的回顾性审查.
- 放射科医生使用TI-RADS盲目评分超声波.
- 对TI-RADS管理准则的评估和为最佳儿科FNAB截止值建模.
主要成果:
- 在96个结节中,52%是恶性;82%的患者是女性 (平均年龄为16.1岁).
- 对于恶性瘤预测的TI-RADS AUC为0.78.
- 修改后的指导方针通过调整FNAB大小值,将错过的恶性瘤从4%降低到0%.
结论:
- TI-RADS对儿童甲状腺结节的风险分层有效.
- 修改是必要的,以尽量减少儿童错过的恶性瘤.
- 建议在儿科患者中使用较低的FNAB尺寸值.
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