Purpose To simplify the assignment process of thyroid imaging report and data system(TI-RADS)and propose a new grading system,and to explore the feasibility of simplified TI-RADS(sTI-RADS)in predicting the capsule invasion of thyroid cancer.Materials and Methods The ultrasonograms of 749 cases of thyroid nodules were retrospectively analyzed from January 2018 to January 2021 in Beijing Tiantan Hospital,Capital Medical University.According to the pathological results,all patients were divided into 230 cases in benign nodule group and 519 cases in malignant nodule group.The ultrasonic signs of nodules in the two groups were collected and the odds ratio(OR)value was calculated(OR>1,assigned 1 score;OR<1,assigned 0 score).The efficiency of sTI-RADS in differentiating benign and malignant nodules was evaluated by receiver operating characteristic curve.According to the surgical results,265 malignant nodules with clear relationship with capsule were screened and divided into 67 cases with capsule invasion and 198 cases without capsule invasion.The ultrasound and clinical data of the two groups were analyzed by univariate analysis and Logistic regression analysis.Results The evaluation results of 749 thyroid nodules were 0,1,2,3,4 and 5 points,and the corresponding malignant rates were 1.52%,7.69%,38.24%,76.00%,90.75%and 93.75%,respectively.When≥3 points were taken as the cutoff value for the diagnosis of thyroid malignant nodules,the sensitivity and specificity were 94.03%and 67.39%,respectively.The classification of sTI-RADS was as follows:sTI-RADS 3,0 points,malignant rate<2%;sTI-RADS 4a,1 point,malignant rate 2%-10%;sTI-RADS 4b,2 points,malignant rate 10%-50%;sTI-RADS 4c,3 points,malignant rate 50%-90%;sTI-RADS 5,4 or 5 points,malignant rate>90%.There was significant difference in capsule involvement and sTI-RADS between the capsule invasion and the non-capsule invasion groups(χ2/t=12.88,-1.26,P≤0.2),respectively.Capsule involvement by conventional ultrasound was an independent predictor of thyroid cancer capsule invasion(P<0.01),and sTI-RADS was not an independent predictor of thyroid cancer capsule invasion (P=0.80). Conclusion sTI-RADS has a high diagnostic efficiency in the differential diagnosis of benign and malignant thyroid nodules. The grade of sTI-RADS of the thyroid cancer capsule invasion group is significantly higher than that of non-capsule invasion group, and the capsule involvement seen by conventional ultrasound is an independent predictor of thyroid cancer capsule invasion.
Thyroid neoplasmsThyroid imaging report and data systemUltrasonographyNeoplasm gradingMalignant rateThyroid capsule
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