Pattern Recognition of Benign Nodules at Ultrasound of the Thyroid: Which Nodules Can Be Left Alone?
Pattern Recognition of Benign Nodules at Ultrasound of the Thyroid: Which Nodules Can Be Left Alone?
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DOI：
10.2214/ajr.08.1820
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发表时间：
2009-07-01
影响因子：
5
通讯作者：
Yee, Joseph
中科院分区：
文献类型：
--
作者：
Bonavita, John A.;Mayo, Jason;Yee, Joseph
OBJECTIVE.本研究的目的是评估形态学特征预测良性甲状腺结节。从2005年至2007年期间由细胞学和放射学部门在一家机构联合进行的1，232例细针穿刺活检记录的登记处中，确定了650例患者的病例，这些患者的病理报告和超声图像都可用。根据生成的结核清单，对前500个结核进行了审查。我们分析了个体超声特征和10种离散的可识别形态学模式在预测良性组织学发现中的准确性。我们发现，将甲状腺结节分组为可重复的形态学模式或模式识别，而不是分析单个超声特征，在识别良性结节方面非常准确。四个具体的模式被确定为：海绵状结构，囊肿与胶凝块，长颈鹿模式，弥漫性高回声，其中有100%的良性特异性。在我们的系列研究中，识别出具有这四种类型之一的结节可以避免超过60%的甲状腺活检。识别特定的形态学模式是一种准确的方法，以确定良性甲状腺结节，不需要细胞学评价。使用这种方法可以大大减少不必要的活检程序的数量。
OBJECTIVE. The purpose of this study was to evaluate morphologic features predictive of benign thyroid nodules.MATERIALS AND METHODS. From a registry of the records of 1,232 fine-needle aspiration biopsies performed jointly by the cytology and radiology departments at a single institution between 2005 and 2007, the cases of 650 patients were identified for whom both a pathology report and ultrasound images were available. From the alphabetized list generated, the first 500 nodules were reviewed. We analyzed the accuracy of individual sonographic features and of 10 discrete recognizable morphologic patterns in the prediction of benign histologic findings.RESULTS. We found that grouping of thyroid nodules into reproducible patterns of morphology, or pattern recognition, rather than analysis of individual sonographic features, was extremely accurate in the identification of benign nodules. Four specific patterns were identified: spongiform configuration, cyst with colloid clot, giraffe pattern, and diffuse hyperechogenicity, which had a 100% specificity for benignity. In our series, identification of nodules with one of these four patterns could have obviated more than 60% of thyroid biopsies.CONCLUSION. Recognition of specific morphologic patterns is an accurate method of identifying benign thyroid nodules that do not require cytologic evaluation. Use of this approach may substantially decrease the number of unnecessary biopsy procedures.