Comparison of the diagnostic performance of three ultrasound thyroid nodule risk stratification systems for medullary carcinoma of the thyroid: ATA guideline, ACR TI-RADS and C-TIRADS

PAN Zuxian; LI Xiaoyu; XU Shangyan; ZHAN Weiwei

doi:10.19732/j.cnki.2096-6210.2022.05.004

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Comparison of the diagnostic performance of three ultrasound thyroid nodule risk stratification systems for medullary carcinoma of the thyroid: ATA guideline, ACR TI-RADS and C-TIRADS

更新时间：2025-12-15

- Comparison of the diagnostic performance of three ultrasound thyroid nodule risk stratification systems for medullary carcinoma of the thyroid: ATA guideline, ACR TI-RADS and C-TIRADS
- Vol. 31, Issue 5, Pages: 477-483(2022)
- 作者机构：
  
  1. 昆明理工大学医学院,云南,昆明,650000
  2. 上海交通大学医学院附属瑞金医院超声科,上海,200025
- 作者简介：
- 基金信息：
- DOI：10.19732/j.cnki.2096-6210.2022.05.004
  CLC：
- Published Online：28 October 2022，
  
  Published：28 October 2022
- 稿件说明：
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潘祖贤,李晓钰,徐上妍,等. 比较3种超声甲状腺结节风险分层系统对甲状腺髓样癌的诊断性能：ATA指南、ACR TI-RADS和C-TIRADS[J]. 肿瘤影像学, 2022, 31(5): 477-483 https://doi.

org/10.19732/j.cnki.2096-6210.2022.05.004
潘祖贤,李晓钰,徐上妍,等. 比较3种超声甲状腺结节风险分层系统对甲状腺髓样癌的诊断性能：ATA指南、ACR TI-RADS和C-TIRADS[J]. 肿瘤影像学, 2022, 31(5): 477-483 https://doi. DOI： 10.19732/j.cnki.2096-6210.2022.05.004.

org/10.19732/j.cnki.2096-6210.2022.05.004 DOI：

摘要

目的：

比较2015年美国甲状腺协会（American Thyroid Association，ATA）指南、2017年美国放射学会（American College of Radiology，ACR）甲状腺影像报告和数据系统（Thyroid Imaging Reporting and Data System，TI-RADS）和2020年中国甲状腺影像报告和数据系统（Chinese-TIRADS，C-TIRADS）对甲状腺髓样癌（medullary carcinoma of the thyroid，MTC）的诊断性能。

方法：

纳入2012年6月2016年2月于上海交通大学医学院附属瑞金医院就诊经手术后病理学检查证实的204例患者的206个甲状腺结节，回顾并分析甲状腺结节的位置、大小、回声、内部结构、A/T比、边缘、钙化及血流程度，分别根据ATA指南、ACR TI-RADS和C-TIRADS进行风险分类，绘制受试者工作特征（receiver operating characteristic，ROC）曲线并比较诊断效能。

结果：

MTC与甲状腺良性结节相比，MTC的声像图特征多表现为低回声，实性，可见钙化，丰富血供。两组在回声、内部结构、A/T比、边缘、钙化及血供程度比较差异均有统计学意义（

＜0.05）。MTC的风险分级：ATA的高度可疑，ACR TI-RADS的TR5，C-TIRADS 4C和4B，3个系统两两之间比较差异有统计学意义（

＜0.05）。经过ROC曲线分析，C-TIRADS的曲线下面积（area under curve，AUC）最高，灵敏度、阴性预测值最高（74.2%、87.9%），ACR TI-RADS的特异度最高（88.6%），3个系统两两之间AUC比较差异有统计学意义（

＜0.05）。

结论：

ATA指南、ACR TI-RADS和C-TIRADS在MTC的诊断中均表现出较好的诊断价值。

Abstract

Objective:

To compare the diagnostic performanc

e of American Thyroid Association (ATA) guideline proposed in 2015

the Thyroid Imaging Report and Data System issued by the American College of Radiology (ACR) in 2017 and 2020 Chinese Ultrasound Thyroid Imaging Reporting and Data System (C-TIRADS) in medullary carcinoma of the thyroid (MTC).

Methods:

The study included 206 thyroid nodules of 204 patients who were confirmed by surgery in Ruijin Hospital

Shanghai Jiaotong University School of Medicine from June 2012 to February 2016. Retrospectively analyzed the location

size

echo

internal structure

aspect ratio

margin

calcification and vascularity of thyroid nodules. Risk classification was carried out according to the three systems. Then the receiver operating characteristic (ROC) curves were drawn and the diagnostic efficiency was compared.

Results:

The sonographic features of MTC were mostly hypoechoic

solid

calcified and rich blood supply. There were significant differences between MTC and benign thyroid nodules in echo

internal structure

A/T ratio

margin

calcification and blood supply (

＜0.05). Most MTC patients were classified as highly suspicious of ATA guideline

TR5 of ACR TI-RADS

and 4C and 4B of C-TIRADS. There was statistical significance between the two of the three systems (

＜0.05). ROC curve analysis showed that the area under curve (AUC) of C-TIRADS was the largest

the sensitivity and negative predictive value were the highest (74.2%

87.9%)

but the specificity of ACR TI-RADS was the highest (88.6%). The AUC comparison between two of the three systems was statistically significant (

＜0.05).

Conclusion:

C-TIRADS

ATA and ACR TI-RADS showed good diagnostic value in the diagnosis of MTC patients.

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