Ozel Alper, Erturk Sukru Mehmet, Ercan Alkin, Yılmaz Banu, Basak Tulay, Cantisani Vito, Basak Muzaffer, Karpat Zeki
Sisli Etfal Research and Training Hospital, Radiology Department, Istanbul, Turkey.
Med Ultrason. 2012 Mar;14(1):24-8.
The purpose of this study was to define the criteria for use in differentiating benign and malignant nodules with the help of the receiver operating characteristic analysis and to increase the objective diagnostic accuracy of ultrasonography.
A total of 363 patients (307 women, 56 men) with 363 nodules (22 malignant and 341 benign nodules) were included in the study. The presence and absence of each US feature of the evaluated nodule - shape taller than wide, irregular margin, hypoechogenicity, microcalcification, and intranodular vascularity - were scored 1 and 0, respectively. The total ultrasound score was obtained by the summing up of each positive ultrasound findings for malignancy. The effect of the total US score in the discrimination of benign and malignant nodules was analysed using ROC analysis.
The cut off values of US score at maximum sensitivity and specificity for nodules larger and smaller than one centimeter were two (Az: 0.783) and three (Az: 0.935), respectively. For nodules greater than one centimeter, the calculated diagnostic performances including sensitivity, specificity, positive predictive value and negative predictive value, and accuracy were 62.5%, 91.5%, 30.3%, 97.7%, and 89,9%, respectively. For nodules smaller or equal to one centimeter; the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 83.3%, 94.9%, 62.5%, 98.2% and 93.8%, respectively.
Using ultraound, thyroid nodules can be characterized effectively. The number of the US features used in this distinction varies in respect to the nodule size.
本研究旨在借助受试者操作特征分析确定鉴别良性和恶性结节的标准，提高超声检查的客观诊断准确性。
本研究纳入了363例患者（307例女性，56例男性），共363个结节（22个恶性结节和341个良性结节）。对评估结节的每个超声特征——纵横比大于1、边缘不规则、低回声、微钙化和结节内血管——的有无分别评分为1和0。通过将每个提示恶性的阳性超声表现相加得到总超声评分。使用ROC分析评估总超声评分在鉴别良性和恶性结节中的作用。
对于直径大于和小于1厘米的结节，在最大灵敏度和特异度时的超声评分临界值分别为2（曲线下面积：0.783）和3（曲线下面积：0.935）。对于直径大于1厘米的结节，计算得到的诊断性能指标包括灵敏度、特异度、阳性预测值、阴性预测值和准确度分别为62.5%、91.5%、30.3%、97.7%和89.9%。对于直径小于或等于1厘米的结节，灵敏度、特异度、阳性预测值、阴性预测值和准确度分别为83.3%、94.9%、62.5%、98.2%和93.8%。
使用超声可以有效地对甲状腺结节进行特征性描述。用于这种鉴别的超声特征数量因结节大小而异。
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