Características ultrasonográficas de los nódulos tiroideos malignos sin indicación de aspiración con aguja fina según la escala ACR-TIRADS
DOI:
https://doi.org/10.24220/2318-0897v33a2025e8608Palabras clave:
Biópsia por Agulha Fina, Carcinoma de Tireoide, Diagnóstico por ultrassomResumen
Meta Evaluar las características de los nódulos sometidos a aspiración con aguja fina (BAAF) con o sin indicación del sistema de datos e informes de imágenes tiroideas del American College of Radiology (ACR TI-RADS) y las características ultrasonográficas de los nódulos malignos sin indicación de BAAF. Métodos Estudio observacional retrospectivo realizado en el hospital X desde enero de 2011 hasta diciembre de 2021. Se compararon los casos de tiroidectomía con o sin indicación de PAAF mediante el sistema TI-RADS y el perfil ultrasonográfico de nódulos sin indicación de punción. En el cálculo de la razón de probabilidad ajustada, se utilizó un intervalo de confianza del 95%. Los factores de confusión fueron: edad y tamaño. Resultados Los nódulos sometidos a tiroidectomía se dividieron en 2 grupos: con (n = 203/56,38%) y sin (n =157/43,61%) indicación de PAAF por TI-RADS. En el cálculo de la razón de momios ajustada para PAAF indicada o no, no hubo impacto significativo entre Bethesda 4-6 o categorías anatomopatológicas con características malignas. Hubo 105 casos de carcinoma sin indicación de PAAF, con características que aumentaban la probabilidad de malignidad, nódulo menor de 1 cm (OR=2.916 IC95% 1.377-6.177), forma sólida (OR=3.831 IC95% 1.894-7.747), ecogenicidad hipoecoica (OR=4,593 IC 95% 2,214-9,527) y puntuación TR4 (RC=7,074 IC 95% 2,922-17,111). Conclusión La indicación de PAAF por la clasificación TI-RADS no incrementó el diagnóstico de carcinomas en nuestra población. El 64,3% de los nódulos no indicados para PAAF por el ACR-TIRADS fueron neoplasias. Las características que facilitaron esta identificación fueron: ser menor de 1 cm, sólido, hipoecoico y clasificado como TI-RADS 4. Otras características no influyeron en la malignidad.Descargas
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