Stacul F, Bertolotto M, De Gobbis F, Calderan L, Cioffi V, Romano A, Zanconati F, Cova M A
UCO di Radiologia, Università di Trieste, Ospedale di Cattinara, Strada di Fiume 449, I-34149 Trieste, Italy.
Radiol Med. 2007 Aug;112(5):751-62. doi: 10.1007/s11547-007-0178-9. Epub 2007 Jul 26.
The purpose of this study was to correlate the diagnosis of benign or malignant thyroid nodules obtained with grey-scale ultrasound (US) and colour-Doppler US with the cytological findings after US-guided fine-needle aspiration (FNA).
Between January 2004 and June 2005, 516 thyroid nodules in 420 patients (181 solitary thyroid nodules and 239 multiple nodules) were prospectively evaluated with US, colour-Doppler US and US-guided FNA. The nodules were classified as sonographically benign, suspicious or malignant in accordance with established US criteria. Cytological findings were classified as inadequate, benign, indeterminate, suspicious or malignant. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of US and colour-Doppler US were evaluated using FNA as the reference procedure.
The sensitivity, specificity, PPV, NPV and overall accuracy values of grey-scale US were 46%, 73%, 34%, 82% and 67%, respectively, for solitary thyroid nodules and 35%, 72%, 14%, 90% and 68%, respectively, for multiple nodules. The evaluation of nodule vascularity with colour-Doppler US produced a slight increase in sensitivity but a slight reduction in specificity.
Thyroid nodules cannot be accurately characterised using grey-scale US or colour-Doppler US.
本研究旨在将灰阶超声（US）和彩色多普勒超声对甲状腺结节良恶性的诊断结果与超声引导下细针穿刺活检（FNA）后的细胞学检查结果进行对比。
2004年1月至2005年6月期间，对420例患者的516个甲状腺结节（181个单发甲状腺结节和239个多发结节）进行了前瞻性的超声、彩色多普勒超声及超声引导下FNA检查。根据既定的超声标准，将结节分为超声检查良性、可疑或恶性。细胞学检查结果分为不充分、良性、不确定、可疑或恶性。以FNA作为参考程序，评估超声和彩色多普勒超声的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）及诊断准确性。
对于单发甲状腺结节，灰阶超声的敏感性、特异性、PPV、NPV及总体准确率分别为46%、73%、34%、82%和67%；对于多发结节，分别为35%、72%、14%、90%和68%。彩色多普勒超声对结节血管情况的评估使敏感性略有提高，但特异性略有降低。
仅使用灰阶超声或彩色多普勒超声无法准确判断甲状腺结节的特征。
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