Diagnostic value of ultrasound in the evaluation of the echostructures of the nodular formation of the thyroid gland using the classification system TI-RADS

Abstract

Objective. Estimation of the ultrasonographic criteria efficacy in accordance to the TI-RADS system while determining the morphological structures of nodal thyroid affections. Materials and methods. Results of ultrasonographic investigation in 546 patients, ageing 17 - 76 old and suffering thyroidal nodal affections, were analyzed. All the patients were divided into two groups. Into the firsr group (the main) 427 (78.2%) patients were included, to whom ultrasonographic investigation was performed by a surgeon-endocrinologist. Into the second group (the control one) 119 (21.8%) patients were included, to whom ultrasonographic investigation was performed by a radiologist. Ultrasonographic criteria with nodal thyroidal affections were estimated in accordance to the TI-RADS scale, and the results of cytological investigations of the nodal affections - in accordance to criteria of the Bethesda system. The degree of the malignant nodal affections risk was determined, taking into account a quantity of intranodal echographic signs in accordance to the points gradation, using a Ti-RADS system. Results. In accordance to results of pathohistological investigations of the removed specimen a benign changes were revealed in 128 (76.6%) patients, and malignant - in 39 (23.4%). In structure of malignant affections papillary cancer was established in 23 patients, follicular - in 13, medullary - in 2, Hurtle-cellular - in 1 patient. In accordance to cytological investigations, conducted in 2014 - 2018 yrs., there was established, that in the first group a fine-needle biopsy was conducted in 211/427(49.4%) patients. Operative interventions were performed in 105 (24.6%) patients. In the second group a fine-needle biopsy was performed in 64/119 (53.8%) patients. Operative intervention was conducted in 62 (52.1%) patients. Conclusion. While conduction of ultrasonographic investigation by a surgeon-endocrinologist the rate of revealing of false-positive echographic signs have lowered in more than 2 times (1.4%), comparing with analogous index while conduction of the investigation by radiologist (3.1%). Application of a TI-RADS classification have permitted to reduce the rate of the fine-needle biopsy and doing of surgical interventions.

Keywords

• thyroid gland; nodal affections; ultrasonographic investigation; a ti-rads scale, the bethesda criteria