Panta Om Biju, Gurung Ghanashyam, Pradhan Sunil
Department of Radiodiagnosis, Janaki Medical College, Janakpur, Nepal.
Department of Intervention Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Ultrasound. 2018 Apr-Jun;26(2):90-93. doi: 10.4103/JMU.JMU_7_17. Epub 2018 May 7.
Ultrasound (USG) can be a good screening tool to identify high-risk nodule requiring fine-needle aspiration cytology (FNAC). The study aimed to assess the association of USG characteristic of thyroid nodule with malignancy.
A cross-sectional study was performed from August 2011 to July 2012 at Tribhuvan University Teaching Hospital. Patients referred for USG of the neck with thyroid nodule more than 10 mm were offered FNAC and included in the study after taking informed consent. USG characteristics were compared with histopathologic diagnosis of benign or malignant nodule.
USG characteristics significantly ( < 0.05) associated with malignancy were as follows: size of thyroid nodule more than 30 mm, ill-defined margin, solid echotexture, hypoechoic lesion, microcalcification, and any form of increased vascularity. High sensitivity was seen in microcalcification, hypoechoic echogenicity, and ill-defined margin and high specificity was seen in ill-defined margin and solid echotexture. Relatively high sensitivity and specificity was found in ill-defined margin.
Texture, size, margin, echogenicity, and vascularity are important factors for discriminating benign from malignant nodule. Hypoechogenicity, vascularity of any type, ill-defined margin, and microcalcification were independent predictors of malignancy. None of the characteristics were sensitive and specific to be used independently as screening tool to identify high risk of malignancy.
超声（USG）可以作为一种很好的筛查工具，用于识别需要进行细针穿刺细胞学检查（FNAC）的高风险结节。本研究旨在评估甲状腺结节的超声特征与恶性肿瘤之间的关联。
2011年8月至2012年7月在特里布万大学教学医院进行了一项横断面研究。对颈部超声检查发现甲状腺结节直径超过10mm的患者进行FNAC，并在获得知情同意后纳入研究。将超声特征与良性或恶性结节的组织病理学诊断进行比较。
与恶性肿瘤显著相关（<0.05）的超声特征如下：甲状腺结节直径超过30mm、边界不清、实性回声、低回声病变、微钙化以及任何形式的血管增多。微钙化、低回声和边界不清的敏感性较高，边界不清和实性回声的特异性较高。边界不清的敏感性和特异性相对较高。
质地、大小、边界、回声和血管是区分良性和恶性结节的重要因素。低回声、任何类型的血管、边界不清和微钙化是恶性肿瘤的独立预测因素。没有一种特征既敏感又特异到足以单独作为筛查工具来识别高恶性风险。
