Diagnostic Value Of C-TIRADS、ACR-TIRADS And EU-TIRADS For Thyroid Nodules In Context Of Hashimoto’s Thyroiditis

Objective:To evaluate the diagnostic effectiveness of thyroid nodules in the context of Hashimoto’s thyroiditis using the Chinese Thyroid Imaging Reporting and Data System(C-TIRADS),the American Society of Radiology Thyroid Imaging Reporting and Data System(ACR-TIRADS),and the European Thyroid Imaging Reporting and Data System(EUTIRADS).To compare the rate of unnecessary puncture of thyroid nodules in the context of Hashimoto’s thyroiditis by three thyroid imaging reporting and data systems.Materials and methods:Patients who underwent thyroid ultrasonography concurrent with thyroidectomy or fine needle aspiration(FNA)in the Lequn branch of the First Hospital of Jilin University from January 2019 to June 2022 were collected retrospectively and continuously,and pathologically confirmed patients with Hashimoto’s thyroiditis complicated with nodules in 88patients(151 nodules).The malignant risk of thyroid nodules in the background of Hashimoto’s was graded separately,and the receiver operating characteristic(ROC)curve was built and analyzed using the pathological results as the gold standard.We examined the three grading systems’ area under the curve(AUC),sensitivity,and specificity.According to the FNA treatment opinions of three TIRADS,the rate of unnecessary puncture were compared.Results:The AUCs of C-TIRADS,ACR-TIRADS and EU-TIRADS were 0.93,0.90,0.85,respectively.The AUCs of C-TIRADS and ACR-TIRADS were significantly higher than those of EU-TIRADS(P<0.001,P<0.01),There was no significant difference in AUC between TIRADS and ACRTIRADS(P=0.08).The optimal cut-off points for the three risk classifications are C-TIRADS>4b,ACR-TIRADS>4,EU-TIRADS>4,and the corresponding specificities are 85.5%,77.6%,and 77.6%,respectively.The specificity of C-TIRADS was higher than that of ACR-TIRADS and EU-TIRADS(both P<0.05).The corresponding sensitivities were 86.7%,88.0%,and 89.3%,respectively,and there was no significant difference among them(all P>0.05).The unnecessary puncture rate of C-TIRADS was lower than that of ACR-TIRADS and EU-TIRADS.Conclusions:1.C-TIRADS and ACR-TIRADS have good diagnostic performance for thyroid nodules in the context of Hashimoto’s thyroiditis,both of which are better than EU-TIRADS.2.C-TIRADS has the highest specificity for diagnosing thyroid nodules in the context of Hashimoto’s thyroiditis.3.C-TIRADS showed a lower rate of unnecessary puncture.