ความสอดคล้องของการวินิจฉัยก้อนต่อมไทรอยด์ด้วยคลื่นเสียงความถี่สูงในระบบ ACR TI-RADS กับผลตรวจชิ้นเนื้อทางพยาธิวิทยาจากการผ่าตัดต่อมไทรอยด์ ในโรงพยาบาลอุตรดิตถ์

บทคัดย่อ

ABSTRACT
Objective: To evaluate the diagnostic performance of thyroid nodule assessment by ultrasound using the ACR TI-RADS reporting system in predicting thyroid malignancy, compared with histopathological results from thyroidectomy specimens in Uttaradit Hospital.
Methods: This study is a retrospective descriptive study of patients with thyroid nodules who underwent ultrasound examination reported using the ACR TI-RADS system and subsequently received thyroid surgery in Uttaradit Hospital between October 1, 2021 and October 1, 2025.
Results: There were a total of 95 patients included in the study. Of these, 88 were female (92.6%). The mean age was 50 years old (50.42 ± 12.73). The diagnostic performance of ultrasound evaluation using the ACR TI-RADS system for thyroid nodules, compared with histopathological results from thyroidectomy specimens, showed sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and accuracy of 80.6 (95% CI=64.0 - 91.8), 41.3 (95% CI=31.1
- 52.1), 34.9 (95% CI=24.8 - 46.2), 84.4 (95% CI=70.5 - 93.5), 1.37 (95% CI=1.09 - 1.74), 0.47 (95% CI=0.23 - 0.96), 52.34 (95% CI=43.34 - 61.24), respectively.
Conclusions: This study demonstrated that ultrasound evaluation and reporting using the ACR TI-RADS classification system in Uttaradit Hospital are useful for the screening and risk strati􀏐ication of thyroid nodules. The high sensitivity and negative predictive value observed in this study suggest that ACR TI-RADS may help reduce missed diagnoses of thyroid malignancy and assist in identifying patients who require further diagnostic evaluation. However, the relatively low speci􀏐icity and positive predictive value indicate that reliance on ultrasound 􀏐indings alone for surgical decision-making may result in unnecessary thyroid surgeries. Therefore, ultrasound assessment should be interpreted in conjunction with clinical findings, fine-needle aspiration (FNA) cytology results, and other relevant risk factors when planning
patient management and treatment.