Cystic change in thyroid nodules: A confounding factor for real-time qualitative thyroid ultrasound elastography
Cystic change in thyroid nodules: A confounding factor for real-time qualitative thyroid ultrasound elastography
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DOI：
10.1016/j.crad.2011.03.011
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发表时间：
2011-09-01
影响因子：
2.6
通讯作者：
Ahuja, A. T.
中科院分区：
文献类型：
--
作者：
Bhatia, K. S. S.;Rasalkar, D. P.;Ahuja, A. T.
目的：评估实时定性超声弹性成像局灶性甲状腺肿块进行细针穿刺在常规甲状腺ultrasound clinic.MATERIALS和METHODS：94甲状腺结节细针穿刺细胞学在甲状腺超声诊所也进行了实时徒手弹性成像。使用弹性成像评分（ES）量表（1（软）至4（硬）），根据结节实体成分相对于甲状腺实质的硬度对彩色弹性成像进行目视分级。良性和恶性结节的ES和囊性变化对ES的影响进行了分析，使用卡方趋势和Fisher精确检验，p < 0.05用于表示statistical significance.RESULTS：有19乳头状癌，5个转移，57个增生性结节，4个滤泡性腺瘤的基础上确定的细胞学（n =54）或组织学（n = 31）。9个结节因细胞学不确定和无组织学检查而被排除。在恶性肿瘤（均为实体瘤）中，2例ES = 1，4例ES = 2，8例ES = 3，10例ES = 4。良性结节ES = 1者17例，ES = 2者17例，ES = 3者16例，ES = 4者11例。ES > 2在以囊性成分为主的良性结节（17/18）中比轻度囊性（3/12）或完全实性（7/31）良性结节更常见（p = 0.0004，p < 0.0001）。除非排除部分囊性结节（p = 0.005），否则良性和恶性结节之间的ES无显著差异（p = 0.09）。对于实性结节，ES > 2最佳预测恶性肿瘤，达到74%的灵敏度，77%的特异性，和76%accuracy.CONCLUSION：定性实时甲状腺弹性成像预测恶性肿瘤，只有当主要是囊性结节被排除在外，这可能会限制其在常规临床实践中的效用。(C)2011年皇家放射科医师学院。由爱思唯尔有限公司出版。保留所有权利。
OBJECTIVE: To evaluate real-time qualitative ultrasound elastography for focal thyroid masses undergoing fine-needle aspiration in a routine thyroid ultrasound clinic.MATERIALS AND METHODS: Ninety-four thyroid nodules scheduled for fine-needle aspiration cytology in a thyroid ultrasound clinic also underwent real-time freehand elastography. Colour-scaled elastograms were graded visually on the stiffness of the solid component of nodules relative to thyroid parenchyma using an elastography score (ES) scale from 1 (soft) to 4 (stiff). The ES for benign and malignant nodules and the influence of cystic change on ES were analysed using Chi-square with trend and Fishers exact tests, with a p < 0.05 used to indicate statistical significance.RESULTS: There were 19 papillary carcinomas, five metastases, 57 hyperplastic nodules, and four follicular adenomas based on definitive cytology (n =54) or histology (n = 31). Nine nodules were excluded due to indeterminate cytology and no histology. Of malignancies (all solid), two were ES = 1, four were ES = 2, eight were ES = 3, and 10 were ES = 4. Of benign nodules, 17 were ES = 1, 17 were ES = 2, 16 were ES = 3, and 11 were ES = 4. An ES > 2 was more common in benign nodules with predominant cystic components (17/18) than mildly cystic (3/12) or completely solid (7/31) benign nodules (p = 0.0004, p < 0.0001). The ES was not significantly different between benign and malignant nodules (p = 0.09) unless partially cystic nodules were excluded (p = 0.005). For solid nodules, an ES > 2 optimally predicted malignancy, achieving 74% sensitivity, 77% specificity, and 76% accuracy.CONCLUSION: Qualitative real-time thyroid elastography predicts malignancy only if predominantly cystic nodules are excluded, which may limit its utility in routine clinical practice. (C) 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.