Application value of ACR"3-tiered system"in incidental thyroid nodules
[Objective]According to the statistics of incidental thyroid nodule(ITN)cases reported in the various imaging examination,the 3-tiered system of the American Society of Radiology(ACR)was used to evaluate ITN in order to evaluate its application value.[Methods]ITN cases reported in medical imaging examination in our hospital from September 2021 to August 2022 were retrospectively analyed,the maximum diameter of ITN cross section was measured,and Fisher's exact test was used to compare the subsequent ultrasound examination rate of ITN by 3-tiered system of ACR,"American Thyroid Association(ATA)standard"and 20 mm threshold.[Results]Chest CT(including enhancement)reported 3371 cases of ITN,with head and neck CTA reporting ITN accounting for 13.7％of the examination itself.Among the included imaging examinations,3818 cases of ITN(5.2％)were reported,the further ultrasonic examination rate of ITN recommended by 3-tiered system of ACR(33.1％)was significantly lower than that of ITN recommended by"ATA standard"(65.0％)(P＜0.05).The further ultrasonic examination rate of ITN recommended by 3-tiered system(33.1％)was higher than that of ITN recommended by 20 mm threshold evaluation(15.7％)(P＜0.001).[Conclusion]Chest CT is the imaging examination method that reports the most ITN,and head and neck CTA is the examination method that reports the highest proportion of ITN in its examination itself.The 3-tiered system can reduce the rate of further ultrasound examination in ITN,reduce more ITN subsequent ultrasound examination than the"ATA standard".Imaging physicians should combine with the actual situation in our country to reasonably and moderately reduce the reporting rate of ITNs in imaging examinations.
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