Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, Korea.
Yonsei Med J. 2012 Jul 1;53(4):812-9. doi: 10.3349/ymj.2012.53.4.812.
To evaluate malignancy risk according to ultrasound (US) features and size change on follow-up US in mixed echoic thyroid nodules and to suggest management guidelines thereof.
Among patients who underwent US-guided fine needle aspiration biopsy, 316 mixed echoic nodules in 303 patients were included after excluding the patients with pure solid or cystic nodules or without further cytopathologic evaluation. We evaluated malignancy risk according to US features and changes in size and shape on follow-up US.
The malignancy rate was 31.6% (6 of 19) for nodules with suspicious US features and 2.7% (8 of 297) for nodules without suspicious US features (p<0.001). Among 265 nodules with no suspicious US features and initial benign cytology, 15 nodules with suspicious US change and decreased size, 25 nodules with no suspicious US change and increased size, and 225 nodules with no suspicious US change and no change in size were observed on follow-up USs. The malignancy risk thereof was 0%, 0% and 0.4%, respectively (p=1.000).
Mixed echoic nodules with no suspicious US features and benign cytology can be followed up using US, as they revealed very low malignancy rates, even if they showed growth on follow-up US.
评估混合回声甲状腺结节的超声（US）特征和随访 US 大小变化的恶性风险，并提出相应的管理建议。
在接受超声引导下细针抽吸活检的患者中，排除纯实性或囊性结节或无进一步细胞病理学评估的患者后，共有 303 名患者的 316 个混合回声结节纳入本研究。我们根据 US 特征以及随访 US 中大小和形状的变化来评估恶性风险。
可疑 US 特征的结节恶性率为 31.6%（19 个中的 6 个），无可疑 US 特征的结节恶性率为 2.7%（297 个中的 8 个）（p<0.001）。在 265 个无可疑 US 特征且初始细胞学良性的结节中，随访 US 发现 15 个结节的 US 改变具有可疑特征且体积缩小，25 个结节的 US 无变化且体积增大，225 个结节的 US 无变化且体积无变化。其恶性风险分别为 0%、0%和 0.4%（p=1.000）。
无可疑 US 特征且细胞学良性的混合回声结节可以通过超声进行随访，因为即使它们在随访中显示生长，其恶性率也非常低。
