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对于儿童患者甲状腺结节风险分层的ACR-TIRADS的诊断性能

Anita Lavarda Scheinpflug¹, Leonardo Barbi Walter¹, Laura Marmitt¹

¹Thyroid Unit, Hospital de Clínicas de Porto Alegre, Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

|August 12, 2025

概括

美国放射学学院甲状腺成像报告和数据系统 (ACR-TIRADS) 有效地评估了儿科甲状腺结节中的恶性瘤风险. 高风险的TR5结节显示了87.5%的恶性瘤率,表明ACR-TIRADS在这个人群中的实用性.

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:

美国放射学学院甲状腺成像报告和数据系统 (ACR-TIRADS) 是成人甲状腺结节风险分层的标准.
它在儿科群体中的应用正在增长,但需要进一步验证.

研究的目的:

评估ACR-TIRADS分类系统对18岁及以下患者甲状腺结节的诊断性能.
评估儿童甲状腺结节中与不同ACR-TIRADS类别相关的恶性瘤率.

主要方法:

对58名患有甲状腺结节的儿科患者 (65个结节) 进行了回顾性队列研究.
提取了ACR-TIRADS数据,并通过细胞学检查,组织学或超声监测来确定恶性病变.
使用kappa统计数据评估了观察者间的一致性.

主要成果:

总体恶性瘤发生率为20.7%. TR1,TR2和TR3结节都是良性的.
TR4结节的恶性病发病率为14.3%,而TR5结节的恶性病发病率为87.5%.
TR5结节显示出对恶性瘤的高积极预测值 (87.5%) 和特异性 (97.9%). 结节大小不是一个可靠的预测指标.

结论:

ACR-TIRADS有效地分层了儿科甲状腺结节的恶性瘤风险.
TR5结节在儿童中具有显著高的恶性瘤风险.
将临床风险因素与超声波特征相结合,可以比单独的结节大小更好地预测恶性瘤.

关键词:

这就是ACR-TIRADS.儿童甲状腺结节在儿童甲状腺结节儿科甲状腺超声波儿科甲状腺超声波甲状腺成像成像甲状腺成像

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