Thyroid nodules: Is it time to turn off the US machines?
Thyroid nodules: Is it time to turn off the US machines?
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DOI：
10.1148/radiol.2473072233
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发表时间：
2008-06-01
期刊：
影响因子：
19.7
通讯作者：
Cronan, John J.
中科院分区：
文献类型：
--
作者：
Cronan, John J.
分化-多中心回顾性研究”在这个问题的放射学（1）提出了一个组织良好的多中心研究评价超声（US）的结果与甲状腺结节的良性和恶性。我每个月从世界各地的团体中审查一到两篇手稿，希望建立更具体的标准，并最终确定区分良性和恶性结节的组织学特异性。这些美国系列都是甲状腺结节的回顾性评价，强调良性和恶性外观之间的重叠，以及如果精确诊断是目标，则需要进行细针穿刺（FNA）。超声表现的良性和恶性结节的重叠程度足够大，以至于通常需要细胞学FNA样本来诊断良性或恶性结节。超声放射科医师协会共识小组承认，"尽管在美国良性和恶性甲状腺结节的区分有一定的趋势，但它们的表现也有重叠。由于超声特征的预测价值不一致，大多数人认为，在患者因可能的甲状腺恶性肿瘤而接受手术切除之前，通常需要对甲状腺结节进行细针穿刺和细胞病理学评估”（2）。
Differentiation—Multicenter Retrospective Study” in this issue of Radiology (1) present a well-organized multicenter study evaluating ultrasonographic (US) findings associated with benign and malignant thyroid nodules. I review one to two manuscripts a month from groups throughout the world, looking to establish more specific criteria and ultimately define histologic specificity in distinguishing benign from malignant nodules. These US series are all retrospective evaluations of thyroid nodules that emphasize the overlap between benign and malignant appearance, as well as the need to perform fine needle aspiration (FNA) if a precise diagnosis is the goal. The degree of overlap in the US appearance of benign and malignant nodules is great enough that a cytologic FNA sample is usually necessary to make the diagnosis of a benign or malignant nodule. The Society of Radiologists in Ultrasound consensus panel acknowledged that,“[a] lthough there are certain trends in the US distinction of benign and malignant thyroid nodules, there is also overlap in their appearances. Because of the inconsistent predictive value of US features, most agree that FNA and cytopathologic evaluation of a thyroid nodule are usually required before a patient undergoes surgical resection for a possible thyroid malignancy”(2).