Benign and malignant thyroid nodules: US differentiation - Multicenter retrospective study
Benign and malignant thyroid nodules: US differentiation - Multicenter retrospective study
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DOI：
10.1148/radiol.2473070944
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发表时间：
2008-06-01
期刊：
影响因子：
19.7
通讯作者：
Lee, Dong Hoon
中科院分区：
文献类型：
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作者：
Moon, Won-Jin;Jung, So Lyung;Lee, Dong Hoon
目的：以组织诊断为参考标准，回顾性评估超声（US）标准描述良恶性甲状腺结节的诊断准确性。材料和方法：本研究获得机构审查委员会批准，并放弃知情同意。 2003年1月至2003年6月，9家附属医院连续8024名患者接受了甲状腺超声检查。本研究共纳入 831 名患者（716 名女性，115 名男性；平均年龄，49.5 岁+/- 13.8 [标准差]），有 849 个结节（360 个恶性，489 个良性），并在手术或活检中诊断出来。三位放射科医生回顾性评估了超声图像的以下特征：结节大小、海绵状外观、形状、边缘、回声纹理、回声性以及微钙化、宏观钙化或边缘钙化的存在。进行了chi(2)检验和多元回归分析。获得了敏感性、特异性以及阳性和阴性预测值。结果：具有统计学显着性（P < .05）的恶性肿瘤发现为高大于宽的形状（敏感性，40.0%；特异性，91.4%）、毛刺状边缘（敏感性，48.3%；特异性，91.8%）、明显的低回声（敏感性，41.4%；特异性，91.8%）。特异性， 92.2%）、微钙化（敏感性，44.2%；特异性，90.8%）和宏观钙化（敏感性，9.7%；特异性，96.1%）。良性结节的超声检查结果为等回声（敏感性，56.6%；特异性，88.1%；P < .001）和海绵状外观（敏感性，10.4%；特异性，99.7%；P < .001）。存在至少一项恶性超声检查的敏感性为 83.3%，特异性为 74.0%，诊断准确性为 78.0%。对于直径小于或等于1 cm的甲状腺结节，微钙化敏感性低于较大结节（36.6% vs 51.4%，P < .05）。结论：形状、边缘、回声强弱和是否有钙化是区分良恶性结节的有用标准；美国标准的诊断准确性取决于肿瘤大小。 (C) 北美放射学会，2008 年。
Purpose: To retrospectively evaluate the diagnostic accuracy of ultrasonographic (US) criteria for the depiction of benign and malignant thyroid nodules by using tissue diagnosis as the reference standard.Materials and Methods: This study had institutional review board approval, and informed consent was waived. From January 2003 through June 2003, 8024 consecutive patients had undergone thyroid US at nine affiliated hospitals. A total of 831 patients (716 women, 115 men; mean age, 49.5 years +/- 13.8 [standard deviation]) with 849 nodules (360 malignant, 489 benign) that were diagnosed at surgery or biopsy were included in this study. Three radiologists retrospectively evaluated the following characteristics on US images: nodule size, presence of spongiform appearance, shape, margin, echotexture, echogenicity, and presence of microcalcification, macrocalcification, or rim calcification. A chi(2) test and multiple regression analysis were performed. Sensitivity, specificity, and positive and negative predictive values were obtained.Results: Statistically significant (P < .05) findings of malignancy were a taller-than-wide shape (sensitivity, 40.0%; specificity, 91.4%), a spiculated margin (sensitivity, 48.3%; specificity, 91.8%), marked hypoechogenicity (sensitivity, 41.4%; specificity, 92.2%), microcalcification (sensitivity, 44.2%; specificity, 90.8%), and macrocalcification (sensitivity, 9.7%; specificity, 96.1%). The US findings for benign nodules were isoechogenicity (sensitivity, 56.6%; specificity, 88.1%; P < .001) and a spongiform appearance (sensitivity, 10.4%; specificity, 99.7%; P < .001). The presence of at least one malignant US finding had a sensitivity of 83.3%, a specificity of 74.0%, and a diagnostic accuracy of 78.0%. For thyroid nodules with a diameter of 1 cm or less, the sensitivity of microcalcifications was lower than that in larger nodules (36.6% vs 51.4%, P < .05).Conclusion: Shape, margin, echogenicity, and presence of calcification are helpful criteria for the discrimination of malignant from benign nodules; the diagnostic accuracy of US criteria is dependent on tumor size. (C) RSNA, 2008.