Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea.
Thyroid. 2011 Nov;21(11):1249-53. doi: 10.1089/thy.2010.0372. Epub 2011 Aug 30.
A "taller-than-wide" shape is associated with thyroid malignancy, but taller-than-wide in which plane is most accurate is unclear. We determined in which ultrasonography (US) plane a taller-than-wide shape is most predictive of malignancy.
A total of 471 thyroid nodules from 435 patients were studied. The final diagnosis was based on histopathology in 145 nodules in 120 patients, and cytology in the remaining patients. A taller-than-wide shape was defined as a ratio of ≥1, calculated by dividing the anteroposterior diameter by the transverse diameter. Three criteria were formulated as follows: criterion 1, a taller-than-wide in any plane as a suspicious feature; criterion 2, that in the transverse plane; criterion 3, that in the longitudinal plane. The sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (Az) were compared among the three criteria.
Of the 471 lesions, 125 (26.5%) were classified as malignant, and 346 (73.5%) were classified as benign. Criterion 1 showed high sensitivity (68%) and negative predictive value (87.7%), whereas criteria 2 and 3 showed high specificity (83.5% and 94.5%, respectively). The Az vale of criterion 1 was significantly higher than criteria 2 and 3 (p values = 0.0061 and 0.0362, respectively).
A taller-than-wide shape was a useful US feature for predicting thyroid malignancy. Criterion 1, a taller-than-wide shape in either transverse or longitudinal plane, was most accurate and sensitive for predicting thyroid malignancy among the three criteria.
“高大于宽”的形状与甲状腺恶性肿瘤相关，但在哪个平面上的“高大于宽”最为准确尚不清楚。我们旨在确定超声（US）哪个平面上的“高大于宽”形状对恶性肿瘤的预测性最高。
共研究了 435 名患者的 471 个甲状腺结节。最终诊断基于 120 名患者的 145 个结节的组织病理学和其余患者的细胞学。“高大于宽”形状定义为纵横比≥1，通过前后直径除以横径计算得出。制定了以下三个标准：标准 1，任何平面上的“高大于宽”为可疑特征；标准 2，横切面上的“高大于宽”；标准 3，纵切面上的“高大于宽”。比较了三个标准之间的敏感性、特异性、阳性预测值、阴性预测值和受试者工作特征曲线下面积（Az）。
471 个病变中，125 个（26.5%）被归类为恶性，346 个（73.5%）被归类为良性。标准 1 具有较高的敏感性（68%）和阴性预测值（87.7%），而标准 2 和 3 具有较高的特异性（83.5%和 94.5%）。标准 1 的 Az 值明显高于标准 2 和标准 3（p 值分别为 0.0061 和 0.0362）。
“高大于宽”形状是预测甲状腺恶性肿瘤的有用 US 特征。在这三个标准中，标准 1，即横切或纵切面上的“高大于宽”形状，对预测甲状腺恶性肿瘤最为准确和敏感。
