TI-RADS und andere sonografische Klassifikationssystemefür Schilddrüsenknoten

Mehrere Arbeitsgruppen und Fachgesellschaften haben in den letzten Jahren Klassifikationssysteme für die sonografische Dignitätsbeurteilung von Schilddrüsenknoten vorgeschlagen, häufig unter dem Überbegriff „TI-RADS“. Diese Systeme zielen auf eine vereinheitlichte und möglichst umfassende Beurteilung von Knoten anhand definierter sonographischer Kriterien ab. Für verschiedene Befundkonstellationen leitet sich so eine jeweilige Malignomwahrscheinlichkeit ab, und die Rate an unnötigen Feinnadelpunktionen kann nachweislich reduziert werden. Es soll zudem verhindert werden, dass wichtige Einzelaspekte der Malignitätsabschätzung im Befund nicht adressiert werden. Der Beitrag stellt eine Übersicht der relevanten Klassifikationssysteme dar, erläutert die Definitionen der einzelnen sonographischen Kriterien unterstützt durch Bildbeispiele und fasst die aktuelle Evidenz zu den genannten Systemen zusammen.

Abstract

Several workgroups and medical societies have proposed classification systems for assessment of malignancy of thyroid nodules using ultrasound, usually under the term “TI-RADS”. These systems aim at uniform and comprehensive assessment of thyroid nodules based on predefined ultrasound criteria. Specific probabilities of malignancy are derived from different ultrasound patterns, and the rate of unnecessary fine needle aspirations can be reduced evidently. Furthermore, the goal is to ensure that all required ultrasound features for malignancy assessment are addressed in the report. This article provides an overview on the relevant classification systems, outlines the definitions of each ultrasound criterion supported by case examples and summarizes the current evidence on the listed systems.

Schlüsselwörter

TI-RADS - Ultraschall - Schilddrüsenknoten - Dignitätsbeurteilung - Schilddrüsenkarzinom

Keywords

TI-RADS - ultrasound - thyroid nodule - assessment of malignancy - thyroid cancer

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