不适当的甲状腺超声波的因素和结果
Felipe Larios1, David Toro-Tobon1,2, Cristian Soto Jacome1,3,4
1Care and AI Laboratory, Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
JAMA otolaryngology-- head & neck surgery
|August 7, 2025
概括
大约7.6%的甲状腺超声波 (TUS) 被不适当地订购,特别是在年轻的患者和那些由非专家推的患者中. 这种过度使用有助于过度诊断和不必要的程序,突出需要优化TUS利用.
科学领域:
- 内分泌学 在内分泌学.
- 放射学 放射学是一门学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 甲状腺癌的发病率显著增加,主要是由于检测到小状甲状腺癌.
- 甲状腺超声波 (TUS) 的过度利用导致过度诊断,可能导致不必要的患者干预和伤害.
研究的目的:
- 为了确定不适当的TUS (iTUS) 订单的频率.
- 确定与iTUS相关的因素.
- 评估iTUS后的临床结果.
主要方法:
- 对2017年1月至2021年12月期间接受首次TUS的成年患者进行回顾性队列研究.
- 一个自然语言处理模型根据临床指示将TUS订单分类为适当或不适当.
- 分析与iTUS相关的患者,临床医生和遭遇特征.
主要成果:
- 在11,442个TUS订单中,7.6%被归类为不合适.
- 与iTUS相关的因素包括年龄较小,甲状腺功能过高,非内分泌学转诊以及与面对面预约无关的订单.
- 与相应的TUS相比,iTUS与较低的甲状腺结节检测率,活检,甲状腺切除术和癌症诊断率有关.
结论:
- 几乎13个TUS订单中的1个是不合适的,这表明大量的过度使用.
- 需要有针对性的策略来优化TUS的使用,特别是对于年轻的患者和那些被非内分泌学专业转诊的患者.
- 缓解iTUS可以帮助减少甲状腺癌的过度诊断和过度治疗.
相关概念视频
Ultrasonography
6.1K
Ultrasonography is an imaging technique that uses high-frequency sound waves to visualize the body's internal structures. It is a non-invasive and safe procedure that does not involve the use of ionizing radiation, making it widely used in various medical fields. Ultrasonography is used to study heart function, blood flow in the neck or extremities, certain conditions such as gallbladder disease, and fetal growth and development.
During an ultrasonography procedure, a handheld device called...
During an ultrasonography procedure, a handheld device called...
6.1K
Synthesis and Regulation of Thyroid Hormones
5.1K
Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
5.1K
Radiological Investigation I: X-ray and CT
415
Radiological investigations, including X-rays and computed tomography (CT) scans, are critical for diagnosing and evaluating various medical conditions. These imaging techniques provide valuable insights into the body's internal structures, aiding in the detection of abnormalities, assessment of disease progression, and development of treatment strategies. This article delves into two primary radiological investigations, chest X-rays and CT scans, outlining their purpose, procedures, and...
415
Imaging Studies II: Ultrasonography
54
IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
54
The Thyroid Gland
4.4K
The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
4.4K
Ultrasound I: Abdominal Ultrasonography
377
Introduction:
Abdominal ultrasonography, commonly known as abdominal ultrasound, is a vital, non-invasive medical imaging technique widely used in healthcare.
Procedure:
This diagnostic tool allows the clinician to visually inspect internal structures within the abdomen, including vital organs such as the liver, gallbladder, pancreas, kidneys, and spleen.
The abdominal ultrasound process begins with applying a special gel to the patient's skin over the abdomen. This gel enhances the...
Abdominal ultrasonography, commonly known as abdominal ultrasound, is a vital, non-invasive medical imaging technique widely used in healthcare.
Procedure:
This diagnostic tool allows the clinician to visually inspect internal structures within the abdomen, including vital organs such as the liver, gallbladder, pancreas, kidneys, and spleen.
The abdominal ultrasound process begins with applying a special gel to the patient's skin over the abdomen. This gel enhances the...
377


