A study on TIRADS classification system in the risk stratification of thyroid swellings

Irphan Muhammed, P S (2016) A study on TIRADS classification system in the risk stratification of thyroid swellings. Masters thesis, Tirunelveli Medical College, Tirunelveli.

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Abstract

BACKGROUND AND OBJECTIVES: Swellings of thyroid are frequently encountered in surgical practice. Clinical evaluation helps in early diagnosis but it is difficult to distinguish early malignant lesions from the most prevalent benign goiters. Various diagnostic modalities are available to distinguish between benign from malignant thyroid nodules. Ultrasound forms an integral component in the evaluation of thyroid swellings. Thyroid Imaging Recording And Data System (TIRADS) is a classification system for thyroid nodules, which classify them into benign or malignant, based on ultrasound characteristics. Still histopathological examination is the goal standard for the classification of thyroid swellings. This study aims to assess the accuracy of TIRADS classification in the evaluation of thyroid swellings by comparing with cytological examination reports. METHODOLOGY: A proforma was drafted for the study of all patients presenting with history of palpable thyroid swelling in our hospital. Clinical presentations, FNAC and Ultrasound findings of all cases were documented. Based on ultrasound findings, patients were grouped into different classes of TIRADS and findings compared with FNAC. RESULTS: 100 cases who presented with thyroid swellings were studied and their TIRADS class was compared with the FNAC. Out of the 100 cases, 93 were females and 7 were males, being 13.3 : 1.TIRADS 4b showed maximum frequency with 40 patients. TIRADS 4a included 16 patients, TIRADS 4c included 15 patients, TIRADS 2 included 11 patients, TIRADS 5 included 10 patients, TIRADS 3 included 6 patients and TIRADS 1 included 2 patients. TIRADS 4b, 4c and 5 showed malignant cases. TIRADS 4b showed 7.5% malignant cases. TIRADS 4c showed 66.7% malignancy. TIRADS 5 showed 100% malignancy. INTERPRETATION AND CONCLUSION: The majority of our patients were between third and fourth decade, of which females being predominant. The majority of cases were benign of which colloid goiter being the most dominant pathology (62 %). Among the malignancies, majority were papillary carcinoma (60 %). Ultrasound thyroid is cheap, easy and can be done on outpatient basis. Addition of TIRADS score to clinical suspicion is very much helpful in picking up high risk cases, especially in a country like India where the rural patient load is very high and follow up is not standardized. TIRADS 4b showed 7.5% malignant cases. TIRADS 4c showed 66.7% malignancy. TIRADS 5 showed 100% malignancy.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Fine needle aspiration cytology ; Thyroid nodule ; Thyroid Imaging Recording And Data System ; TIRADS.
Subjects: MEDICAL > General Surgery
Depositing User: Subramani R
Date Deposited: 12 Oct 2017 00:58
Last Modified: 12 Oct 2017 00:58
URI: http://repository-tnmgrmu.ac.in/id/eprint/3540

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