评估TI-RADS在儿科甲状腺结节中的诊断准确性:一个多机构审查
Shachi Srivatsa1, Ameer Al-Hadidi2, Joseph Stanek2
1Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA.
Journal of pediatric surgery
|October 2, 2024
概括
甲状腺成像报告和数据系统 (TI-RADS) 有效评估儿科甲状腺结节,提高恶性瘤预测的准确性. 与当前的指导方针相比,该系统减少了儿童中不必要的细针吸收活检 (FNAB).
科学领域:
- 儿科内分泌学 儿科内分泌学
- 诊断成像 诊断成像 诊断成像
- 在瘤学瘤学.
背景情况:
- 儿童甲状腺结节的恶性瘤风险比成人结节更高.
- 目前美国甲状腺协会 (ATA) 的指导方针依赖于细针吸收活检 (FNAB) 建议的尺寸标准.
- 经过成人验证的甲状腺成像报告和数据系统 (TI-RADS) 提供了基于超声波的甲状腺结节风险分层.
研究的目的:
- 评估TI-RADS在儿童甲状腺结节中预测恶性瘤的性能.
- 将TI-RADS的准确性与ATA尺寸标准进行比较,以指导儿童的FNAB决策.
- 开发和测试一个特定于儿科的TI-RADS (PED TI-RADS) 类别,以优化FNAB的建议.
主要方法:
- 在21岁以下的患者 (2015-2020年) 中,多机构对超声波甲状腺成像的回顾性分析.
- 在TI-RADS标准中受过训练的儿科放射科医生分配的TI-RADS分数.
- 将TI-RADS性能与基于ATA尺寸的FNAB建议进行比较;开发和测试新的PED TI-RADS标准.
主要成果:
- 成人TI-RADS标准建议FNAB用于35.1%的结节,明显低于ATA指南 (76.6%).
- 成人TI-RADS评分≥3显示100%的敏感性和28.5%的特异性恶性瘤,没有错过的病例.
- 新的PED TI-RADS标准节省了88名患者不必要的FNAB,比ATA标准提高了灵敏度和准确性.
结论:
- TI-RADS评分,包括一个新的PED TI-RADS类别,提高了小儿甲状腺结节恶性瘤预测的准确性.
- PED TI-RADS有效地减少了儿童不必要的FNAB,而不会影响对恶性瘤的诊断灵敏度.
- 这种方法提供了一种更准确和更有效的方法来管理小儿甲状腺结节,而不是仅仅根据尺寸标准.
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