Krejbjerg Anne, Brilli Lucia, Pikelis Arunas, Pedersen Henrik Baymler, Laurberg Peter
Departments of Endocrinology (A.K., P.L.) and Ear, Nose, and Throat Head and Neck Surgery (A.P., H.B.P.), Aalborg University Hospital, Aalborg, Denmark; and Department of Endocrinology, University of Siena, Siena, Italy (L.B.).
J Ultrasound Med. 2015 Feb;34(2):309-16. doi: 10.7863/ultra.34.2.309.
The purpose of this study was to evaluate the characteristics of benign thyroid nodules on sonography and ultrasound elastography in a population exposed to iodine deficiency.
We conducted a prospective systematic evaluation of preoperative thyroid sonography and elastography in patients assigned for surgical excision of benign thyroid nodules. Two experienced sonographers performed all sonographic and elastographic examinations. Thyroid nodules were evaluated by 7 generally accepted sonographic malignancy risk markers and assigned an elasticity score on elastography. The final diagnosis of a benign thyroid nodule was based on histopathologic analysis of resected thyroid gland tissue.
We evaluated 232 thyroid nodules in 105 patients (86 women and 19 men). In total, 57% of the examined nodules had 1 or 2 malignancy risk markers present, and 24% did not have any markers present. A solid nodule larger than 15 mm was the most common malignancy risk marker observed (63%), followed by low elasticity (33%), microcalcifications (26%), and hypoechogenicity (15%). In an analysis stratified according to the number of nodules (solitary versus multiple), low elasticity was described more frequently in solitary nodules (61.9% versus 30.4%; P= .004). A large nodular volume was a predictor (P < .05) of microcalcifications and intranodular vascularization, whereas an absent halo sign and a solid nodule were found less frequently in nodules with larger volumes.
Our results show that routine preoperative malignancy risk evaluation of presumably benign thyroid nodules is of little value when performed on patients exposed to iodine deficiency.
本研究旨在评估碘缺乏人群中甲状腺良性结节的超声及超声弹性成像特征。
我们对计划接受手术切除甲状腺良性结节的患者进行了术前甲状腺超声及弹性成像的前瞻性系统评估。两名经验丰富的超声医师进行了所有的超声及弹性成像检查。根据7种普遍认可的超声恶性风险标志物对甲状腺结节进行评估，并在弹性成像上给出弹性评分。甲状腺良性结节的最终诊断基于切除的甲状腺组织的组织病理学分析。
我们评估了105例患者（86例女性和19例男性）的232个甲状腺结节。总共，57%的检查结节有1种或2种恶性风险标志物，24%没有任何标志物。大于15mm的实性结节是最常见的观察到的恶性风险标志物（63%），其次是低弹性（33%）、微钙化（26%）和低回声（15%）。在根据结节数量（单发与多发）分层的分析中，低弹性在单发结节中更常见（61.9%对30.4%；P = 0.004）。大的结节体积是微钙化和结节内血管化的预测因素（P < 0.05），而在体积较大的结节中，无晕征和实性结节较少见。
我们的结果表明，对碘缺乏患者进行术前常规的甲状腺良性结节恶性风险评估价值不大。
