Ultrasound Department, The Affiliated Hospital of Qingdao University, No. 16, Jiangsu Road, Southern Distinct, Qingdao, Shandong, 266003, China.
Radiology Department, The Affiliated Hospital of Qingdao University, Qingdao, China.
Eur Radiol. 2018 Jun;28(6):2612-2619. doi: 10.1007/s00330-017-5212-2. Epub 2018 Jan 8.
The aim of this study was to compare the distribution patterns of microcalcifications in thyroid cancers with benign cases.
In total, 358 patients having microcalcifications on ultrasonography were analysed. Microcalcifications were categorised according to the distribution patterns: (I) microcalcifications inside one (a) or more (b) suspected nodules, (II) microcalcifications not only inside but also surrounding a suspected single (a) or multiple (b) nodules, and (III) focal (a) or diffuse (b) microcalcifications in the absence of any suspected nodule. Differences in distribution patterns of microcalcifications in benign and malignant thyroid lesions were compared.
We found that the distribution patterns of microcalcifications differed between malignant (n = 325) and benign lesions (n = 117) (X = 9.926, p < 0.01). Benign lesions were classified as type Ia (66.7%), type Ib (29.1%) or type IIIa (4.3%). The specificity of type II and type IIIb in diagnosing malignant cases was 100%. Among malignant lesions, 172 locations were classified as type Ia, 106 as type Ib, 12 as type IIa, 7 as IIb, 7 as type IIIa and 19 as type IIIb. Accompanying Hashimoto thyroiditis was most frequent in type III (51.6%).
Types II and IIIb are highly specific for cancer detection. Microcalcifications outside a nodule and those detected in the absence of any nodule should therefore be reviewed carefully in clinical practice.
• A method to classify distribution patterns of thyroid microcalcifications is presented. • Distribution features of microcalcifications are useful for diagnosing thyroid cancers. • Microcalcifications outside a suspicious nodule are highly specific for thyroid cancers. • Microcalcifications without suspicious nodules should also alert the physician to thyroid cancers.
本研究旨在比较甲状腺癌与良性病例中微钙化的分布模式。
总共分析了 358 例超声检查有微钙化的患者。根据分布模式将微钙化分为：（I）微钙化仅位于一个或多个可疑结节内（a）；（II）微钙化不仅位于可疑单个或多个结节内，而且还环绕这些结节（a）；以及（III）在无任何可疑结节的情况下出现局灶性（a）或弥漫性（b）微钙化。比较良性和恶性甲状腺病变中微钙化分布模式的差异。
我们发现恶性（n=325）和良性病变（n=117）之间微钙化的分布模式存在差异（X²=9.926，p<0.01）。良性病变分为 Ia 型（66.7%）、Ib 型（29.1%）或 IIIa 型（4.3%）。Ⅱ型和Ⅲb 型对诊断恶性病例的特异性为 100%。在恶性病变中，172 个部位被分类为 Ia 型，106 个部位为 Ib 型，12 个部位为 IIa 型，7 个部位为 IIb 型，7 个部位为 IIIa 型，19 个部位为 IIIb 型。桥本甲状腺炎在 III 型中最常见（51.6%）。
Ⅱ型和Ⅲb 型对癌症检测具有高度特异性。因此，在临床实践中应仔细检查结节外的微钙化和无结节时发现的微钙化。
• 提出了一种分类甲状腺微钙化分布模式的方法。• 微钙化的分布特征有助于诊断甲状腺癌。• 可疑结节外的微钙化对甲状腺癌具有高度特异性。• 无可疑结节的微钙化也应引起医生对甲状腺癌的警惕。
