Lee Young Chan, Jung Ah Ra, Sohn Yu-Mee, Kim Eui-Jong, Eun Young-Gyu
Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, #1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, South Korea.
Department of Radiology, Kyung Hee University School of Medicine, Seoul, South Korea.
Eur Arch Otorhinolaryngol. 2018 Nov;275(11):2817-2822. doi: 10.1007/s00405-018-5115-0. Epub 2018 Sep 3.
To assess the ultrasonographic features affect accuracy of extrathyroid extension (ETE) evaluation on preoperative ultrasonography (US) in papillary thyroid microcarcinoma (PTMC).
Of the total patients who underwent thyroid surgery, 516 patients with a tumor measuring less than 1 cm on preoperative US were enrolled in this study. One blinded head and neck radiologist reviewed the preoperative US images to evaluate the US features of PTMC, and the pathologic reports were reviewed. The diagnostic accuracy rates, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, were calculated, and the factors associated with false-negative and false-positive results for ETE were analyzed.
The sensitivity, specificity, PPV, NPV, and accuracy for predicting ETE according to sonographic criteria were 32.8%, 87.5%, 51.0%, 76.6%, and 71.7%, respectively. Non-adjacent to the trachea and unilateral lesion on US were significant factors associated with false-negative results.
Size, shape, and location of PTMC on US are important factors that affect the US results in ETE evaluation.
评估超声特征对术前超声（US）评估甲状腺微小乳头状癌（PTMC）甲状腺外侵犯（ETE）准确性的影响。
在接受甲状腺手术的所有患者中，本研究纳入了516例术前超声检查肿瘤直径小于1 cm的患者。一名头颈放射科医生在不知情的情况下回顾术前超声图像以评估PTMC的超声特征，并查阅病理报告。计算诊断准确率，包括敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性，并分析与ETE假阴性和假阳性结果相关的因素。
根据超声标准预测ETE的敏感性、特异性、PPV、NPV和准确性分别为32.8%、87.5%、51.0%、76.6%和71.7%。超声显示不与气管相邻及单侧病变是与假阴性结果相关的重要因素。
PTMC在超声上的大小、形态和位置是影响ETE超声评估结果的重要因素。
