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 (

P

＜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 (

P

＜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 (

P

＜0.05).

Conclusion:

C-TIRADS

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