Poster électronique

Score TIRADS pour les nodules thyroïdiens
G. Russ, C. Bigorgne, B. Royer, A. Rouxel - Paris - France
Congrès 2010
Poster
4
226 votes.
Vu 20548 fois.
Résumé
Objectifs
Développer un lexique d’imagerie ultrasonore de la thyroïde (TI-RADS) destinéà standardiser les descriptions échographiques et les conduites à tenir.
Matériels et méthodes
Étude cas-témoins rétrospective de 500 nodules caractérisés par cytologie et/ou histologie (159 cancers et 341 lésions bénignes). Pour chaque signe ou association de signes échographiques ont été calculés la sensibilité, la spécificité et l’odds-ratio. La connaissance de la prévalence du cancer thyroïdien permet le calcul d’effectifs théoriques tel que dans une étude de cohorte et d’obtenir les valeurs prédictives positive (VPP) et négative et le risque relatif.
Résultats
La VPP est apparue comme le meilleur indicateur pour définir le score TI-RADS : les scores 2,3, 4A, 4B, 4C et 5 correspondent respectivement à une probabilité de malignité de 0 %, moins de 2 %, 2 à 10 %, 11 à 50 %, 51 à 95 %, plus de 95 %. Echogénicité, structure, présence ou non de microcalcifications ou de macrocalcifications, contours et forme permettent de définir simplement le grade d’un nodule. La sensibilité du score pour le diagnostic de malignité est de 95 %.
Conclusion
Un score échographique des nodules thyroïdiens a été défini pour standardiser le vocabulaire, préciser le risque individuel et la conduite à tenir.
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