Zahir Shokouh Taghipour, Vakili Mahmoud, Ghaneei Azam, Sharahjin Naser Sefidrokh, Heidari Fatemeh
Department of Pathology,Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Department of Community Medicine,Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
J Ayub Med Coll Abbottabad. 2016 Oct-Dec;28(4):644-649.
The search is ongoing for simple, effective ways to identify and differentiate thyroid nodules in order to avoid invasive procedures. This study aims to perform an ultrasound assessment of clinically suspected patients with malignant nodules, to perform a fine needle biopsy on them, and to compare the results obtained.
In total, 135 patients with thyroid nodules suspected to be malignant in the ultrasound underwent ultrasound-guided fine needle biopsies. The patients' gender, age, ultrasound views (echogenicity, shape, and calcification type), nodule size, number of nodules, and needle biopsy results were retrospectively evaluated.
Of the 135 patients, 117 (86.7%) were female and 18 (13.3%) were male. In terms of age, 67 (49.16%) were younger than 40 and the rest were older. According to the Chi-square test, a significant relationship was found between the type of nodule and calcification found in the ultrasound views (p=0.001). The nodule type was not significantly related to gender (p=0.563) or to the number of nodules (p=0.128); however, there was a significant relationship between nodule size and type (p=0.001). Ultrasound specificity, sensitivity, positive and negative predictive values, and accuracy for differentiating benign from malignant nodules were 93.2%, 93.8%, 81.1%, 98%, and 93.3%, respectively.
Ultrasound views (comet tail artefact and linear echogenic foci) were better predictors of benign nodules than of malignant ones, while round, echogenic foci, brighter and larger than typical micro-calcifications without any visible echoes and multiple punctuate round echogenic foci were better predicted malignancy.
人们一直在寻找简单有效的方法来识别和区分甲状腺结节，以避免进行侵入性手术。本研究旨在对临床怀疑有恶性结节的患者进行超声评估，对其进行细针穿刺活检，并比较所得结果。
共有135例超声怀疑为恶性的甲状腺结节患者接受了超声引导下细针穿刺活检。对患者的性别、年龄、超声表现（回声、形状和钙化类型）、结节大小、结节数量及穿刺活检结果进行回顾性评估。
135例患者中，女性117例（86.7%），男性18例（13.3%）。年龄方面，67例（49.16%）小于40岁，其余年龄较大。根据卡方检验，在超声表现中发现的结节类型与钙化之间存在显著相关性（p = 0.001）。结节类型与性别（p = 0.563）或结节数量（p = 0.128）无显著相关性；然而，结节大小与类型之间存在显著相关性（p = 0.001）。超声区分良性与恶性结节的特异性、敏感性、阳性和阴性预测值及准确性分别为93.2%、93.8%、81.1%、98%和93.3%。
超声表现（彗星尾伪像和线状回声灶）对良性结节的预测优于恶性结节，而圆形、回声灶、比典型微钙化更亮、更大且无任何可见回声以及多个点状圆形回声灶则更倾向于预测为恶性。
