The Diagnostic Value of Thyroid Imaging Reporting and Data System Combined with Sonography in Elastography for Thyroid Nodule_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 HEYu-shuang , JINYa ,  MABu-yun , ZHAOHai-na , PENGYu-lan

Department of Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding author：

MABu-yun, Email: ws_mby@126.com

Keywords：

Thyroid imaging reporting and data system; Elasticity imaging techniques; Ultrasound; Thyroid nodule

DOI：

10.7507/1007-9424.20140261

Video：

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Objective To evaluate the diagnostic performance of thyroid imaging reporting and data system (TI-RADS)classification and elastography in differentiating benign and malignant thyroid nodules according to size. Methods A total of 222 thyroid nodules (209 cases) with solid or predominantly solid internal contentdiagnosed at pathological findings were enrolled in this study, all the 209 cases underwent surgery in our hospital from Jan.2014 to Jun.2014. The diagnostic performance of TI-RADS classification and elastography in differentiating benign and malignant thyroid nodules according to size nodules were evaluated (for≤1 cm and > 1 cm respectively). Results By using TI-RADS category and elastography, 178 thyroid nodules were diagnosed as malignant nodules, and 44 thyroid nodules were diagnosed as benign nodules. The high predictive factors for malignant thyroid nodules of > 1 cm were irregular shape(OR=6.376), microcalcification(OR=21.525), and capsule invasion(OR=3.852), P < 0.05. The factors for thyroid nodules of≤1 cm were anteroposterior to transverse diameter ratio≥1(OR=3.406), capsule invasion (OR=3.922), and high elastography score(OR=1.606), that suggested the possibility of malignant (P < 0.05). For nodules of > 1 cm, the sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and Youden index of TI-RADS combining with elastography were 98.3%(59/60), 68.6%(24/35), 87.4%(83/95), 84.3%(59/70), 96.0% (24/25), and 66.9% respectively; for nodules of≤1 cm, the sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and Youden index were 98.5%(67/68), 30.5%(18/59), 66.9%(85/127), 62.0%(67/108), 94.7%(18/19), and 29.0% respectively. Conclusion TI-RADS category combined with elastography for diagnosis of thyroid nodules in different size has just a bit differently diagnostic indicators, but that play a high diagnostic performance on the thyroid nodules with maximum diameter > 1 cm.

Citation： HEYu-shuang, JINYa, MABu-yun, ZHAOHai-na, PENGYu-lan. The Diagnostic Value of Thyroid Imaging Reporting and Data System Combined with Sonography in Elastography for Thyroid Nodule. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(9): 1081-1086. doi: 10.7507/1007-9424.20140261 Copy

1.	彭玉兰, 罗燕, 张卫东, 等.老年人甲状腺结节及甲状腺功能的相关性探讨[J]. 中华老年医学杂志, 2005, 24(4):290-291.
2.	刘星君, 滕卫平, 施秉银, 等.健康成人甲状腺结节4306例患病情况调查[J]. 第四军医大学学报, 2009, 30(19):1982-1984.
3.	乔令艳, 宋心红, 林海燕, 等.健康人群中甲状腺结节患病情况调查[J]. 山东大学学报:医学版, 2010, 48(8):5-7.
4.	Horvath E, Majlis S, Rossi R, et al.An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management[J]. J Clin Endocrinol Metab, 2009, 94(5):1748-1751.
5.	Park JY, Lee HJ, Jang HW, et al.A proposal for a thyroid imaging reporting and data system for ultrasound features of thyroid carcinoma[J]. Thyroid, 2009, 19(11):1257-1264.
6.	徐智章, 俞清.超声弹性成像原理及初步应用[J]. 上海医学影像, 2005, 14(1):3-5.
7.	Fagin JA, Mitsiades N.Molecular pathology of thyroid cancer:diagnostic and clinical implications[J]. Best Pract Res Clin Endocrinol Metab, 2008, 22(6):955-969.
8.	Papini E, Guglielmi R, Bianchini A, et al.Risk of malignancy in nonpalpable thyroid nodules:predictive value of ultrasound and color-Doppler features[J]. J Clin Endocrinol Metab, 2002, 87(5):1941-1946.
9.	马步云, Sundar PS, 彭玉兰, 等.甲状腺影像报告和数据系统在超声检查甲状腺结节中的应用[J]. 中国普外基础与临床杂志, 2011, 18(8):898-901.
10.	Moon HJ, Kim EK, Kwak JY.Malignancy risk stratification in thyroid nodules with benign results on cytology:combination of thyroid imaging reporting and data system and Bethesda system[J]. Ann Surg Oncol, 2014, 21(6):1898-1903.
11.	Ko SY, Lee HS, Kim EK, et al.Application of the thyroid imaging reporting and data system in thyroid ultrasonography interpretation by less experienced physicians[J]. Ultrasonography, 2014, 33(1):49-57.
12.	Wei X, Li Y, Zhang S, et al.Thyroid imaging reporting and data system (TI-RADS) in the diagnostic value of thyroid nodules:a systematic review[J]. Tumour Biol, 2014, 35(7):6769-6776.
13.	Russ G, Royer B, Bigorgne C, et al.Prospective evaluation of thyroid imaging reporting and data system on 4550 nodules with and without elastography[J]. Eur J Endocrinol, 2013, 168(5):649-655.
14.	Kwak JY, Han KH, Yoon JH, et al.Thyroid imaging reporting and data system for US features of nodules:a step in establishing better stratification of cancer risk[J]. Radiology, 2011, 260(3):892-899.
15.	詹维伟, 徐上妍.甲状腺结节超声检查新进展[J/CD]. 中华医学超声杂志:电子版, 2013, 10(2):88-93.
16.	Yoon SJ, Yoon DY, Chang SK, et al."Taller-than-wide sign" of thyroid malignancy:comparison between ultrasound and CT[J]. AJR Am J Roentgenol, 2010, 194(5):W420-W424.
17.	Moon WJ, Jung SL, Lee JH, et al.Benign and malignant thyroid nodules:US differentiation-multicenter retrospective study[J]. Radiology, 2008, 247(3):762-770.
18.	Wang N, Xu Y, Ge C, et al.Association of sonographically detected calcification with thyroid carcinoma[J]. Head Neck, 2006, 28(12):1077-1083.
19.	Kwak JY, Kim EK, Son EJ, et al.Papillary thyroid carcinoma manifested solely as microcalcifications on sonography[J]. AJR Am J Roentgenol, 2007, 189(1):227-231.
20.	Vidal-Casariego A, López-González L, Jiménez-Pérez A, et al. Accuracy of ultrasound elastography in the diagnosis of thyroid cancer in a low-risk population[J]. Exp Clin Endocrinol Diabetes, 2012, 120(10):635-638.
21.	Khoo ML, Asa SL, Witterick IJ, et al.Thyroid calcification and its association with thyroid carcinoma[J]. Head Neck, 2002, 24(7):651-655.
22.	Kim EK, Park CS, Chung WY, et al.New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid[J]. AJR Am J Roentgenol, 2002, 178(3):687-691.
23.	Moon HJ, Kwak JY, Kim MJ, et al.Can vascularity at power doppler US help predict thyroid malignancy?[J]. Radiology, 2010, 255(1):260-269.
24.	周萍, 詹维伟, 任新平, 等.超声弹性成像诊断甲状腺结节的价值[J]. 中国医学影像学杂志, 2009, 17(4):262-265.
25.	俞清, 徐智章, 王文平, 等.甲状腺占位性病变的实时超声弹性成像表现[J]. 中国医学影像技术, 2007, 23(11):1612-1614.
26.	Moon HJ, Sung JM, Kim EK, et al.Diagnostic performance of gray-scale US and elastography in solid thyroid nodules[J]. Radiology, 2012, 262(3):1002-1013.
27.	周瑞莉, 王满立, 王煜, 等.二维超声联合实时超声弹性成像技术诊断甲状腺微小癌的临床分析[J]. 中国超声医学杂志, 2012, 28(5):409-412.

1. 彭玉兰, 罗燕, 张卫东, 等.老年人甲状腺结节及甲状腺功能的相关性探讨[J]. 中华老年医学杂志, 2005, 24(4):290-291.
2. 刘星君, 滕卫平, 施秉银, 等.健康成人甲状腺结节4306例患病情况调查[J]. 第四军医大学学报, 2009, 30(19):1982-1984.
3. 乔令艳, 宋心红, 林海燕, 等.健康人群中甲状腺结节患病情况调查[J]. 山东大学学报:医学版, 2010, 48(8):5-7.
4. Horvath E, Majlis S, Rossi R, et al.An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management[J]. J Clin Endocrinol Metab, 2009, 94(5):1748-1751.
5. Park JY, Lee HJ, Jang HW, et al.A proposal for a thyroid imaging reporting and data system for ultrasound features of thyroid carcinoma[J]. Thyroid, 2009, 19(11):1257-1264.
6. 徐智章, 俞清.超声弹性成像原理及初步应用[J]. 上海医学影像, 2005, 14(1):3-5.
7. Fagin JA, Mitsiades N.Molecular pathology of thyroid cancer:diagnostic and clinical implications[J]. Best Pract Res Clin Endocrinol Metab, 2008, 22(6):955-969.
8. Papini E, Guglielmi R, Bianchini A, et al.Risk of malignancy in nonpalpable thyroid nodules:predictive value of ultrasound and color-Doppler features[J]. J Clin Endocrinol Metab, 2002, 87(5):1941-1946.
9. 马步云, Sundar PS, 彭玉兰, 等.甲状腺影像报告和数据系统在超声检查甲状腺结节中的应用[J]. 中国普外基础与临床杂志, 2011, 18(8):898-901.
10. Moon HJ, Kim EK, Kwak JY.Malignancy risk stratification in thyroid nodules with benign results on cytology:combination of thyroid imaging reporting and data system and Bethesda system[J]. Ann Surg Oncol, 2014, 21(6):1898-1903.
11. Ko SY, Lee HS, Kim EK, et al.Application of the thyroid imaging reporting and data system in thyroid ultrasonography interpretation by less experienced physicians[J]. Ultrasonography, 2014, 33(1):49-57.
12. Wei X, Li Y, Zhang S, et al.Thyroid imaging reporting and data system (TI-RADS) in the diagnostic value of thyroid nodules:a systematic review[J]. Tumour Biol, 2014, 35(7):6769-6776.
13. Russ G, Royer B, Bigorgne C, et al.Prospective evaluation of thyroid imaging reporting and data system on 4550 nodules with and without elastography[J]. Eur J Endocrinol, 2013, 168(5):649-655.
14. Kwak JY, Han KH, Yoon JH, et al.Thyroid imaging reporting and data system for US features of nodules:a step in establishing better stratification of cancer risk[J]. Radiology, 2011, 260(3):892-899.
15. 詹维伟, 徐上妍.甲状腺结节超声检查新进展[J/CD]. 中华医学超声杂志:电子版, 2013, 10(2):88-93.
16. Yoon SJ, Yoon DY, Chang SK, et al."Taller-than-wide sign" of thyroid malignancy:comparison between ultrasound and CT[J]. AJR Am J Roentgenol, 2010, 194(5):W420-W424.
17. Moon WJ, Jung SL, Lee JH, et al.Benign and malignant thyroid nodules:US differentiation-multicenter retrospective study[J]. Radiology, 2008, 247(3):762-770.
18. Wang N, Xu Y, Ge C, et al.Association of sonographically detected calcification with thyroid carcinoma[J]. Head Neck, 2006, 28(12):1077-1083.
19. Kwak JY, Kim EK, Son EJ, et al.Papillary thyroid carcinoma manifested solely as microcalcifications on sonography[J]. AJR Am J Roentgenol, 2007, 189(1):227-231.
20. Vidal-Casariego A, López-González L, Jiménez-Pérez A, et al. Accuracy of ultrasound elastography in the diagnosis of thyroid cancer in a low-risk population[J]. Exp Clin Endocrinol Diabetes, 2012, 120(10):635-638.
21. Khoo ML, Asa SL, Witterick IJ, et al.Thyroid calcification and its association with thyroid carcinoma[J]. Head Neck, 2002, 24(7):651-655.
22. Kim EK, Park CS, Chung WY, et al.New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid[J]. AJR Am J Roentgenol, 2002, 178(3):687-691.
23. Moon HJ, Kwak JY, Kim MJ, et al.Can vascularity at power doppler US help predict thyroid malignancy?[J]. Radiology, 2010, 255(1):260-269.
24. 周萍, 詹维伟, 任新平, 等.超声弹性成像诊断甲状腺结节的价值[J]. 中国医学影像学杂志, 2009, 17(4):262-265.
25. 俞清, 徐智章, 王文平, 等.甲状腺占位性病变的实时超声弹性成像表现[J]. 中国医学影像技术, 2007, 23(11):1612-1614.
26. Moon HJ, Sung JM, Kim EK, et al.Diagnostic performance of gray-scale US and elastography in solid thyroid nodules[J]. Radiology, 2012, 262(3):1002-1013.
27. 周瑞莉, 王满立, 王煜, 等.二维超声联合实时超声弹性成像技术诊断甲状腺微小癌的临床分析[J]. 中国超声医学杂志, 2012, 28(5):409-412.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The Diagnostic Value of Thyroid Imaging Reporting and Data System Combined with Sonography in Elastography for Thyroid Nodule

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