Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
Department of Ultrasound, Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China.
Clin Hemorheol Microcirc. 2020;74(4):373-381. doi: 10.3233/CH-190582.
To identify the associated factors for malignancy in partially cystic thyroid nodules (PCTNs) on ultrasound (US).
This is a retrospective study. 338 PCTNs confirmed by surgery was included in this study. The US features of the nodules were reviewed and their significance in differential diagnosis was analyzed.
In the 338 PCTNs, 50 were malignant and 288 were benign. Univariate analyses revealed that a taller-than-wide shape and spiculated or microlobulated margin were significantly associated with malignancy while the spongy form, an ovoid to round shape and smooth margin were significantly associated with benign nature. In terms of the internal solid portion of the nodule, eccentric configuration, non-smooth margin, hypoechogenicity, and microcalcification were more frequently demonstrated in malignant nodules than in benign ones. In the multivariate logistic regression analysis, a taller than wide shape (OR: 13.357; 95% CIs: 3.457-28.797) was revealed to be the strongest independent predictor for malignancy, followed by microcalcification (OR: 11.578; 95% CIs: 3.142-29.563), spiculated or microlobulated margin (OR: 6.331; 95% CIs: 1.425-9.457), eccentric configuration (OR: 5.456; 95% CIs: 1.358-8.774), non-smooth rim of the internal solid portion (OR: 4.897; 95% CIs: 0.754-7.021), and hypoechogenicity of the internal solid portion (OR: 4.651; 95% CIs: 0.712-8.245).
Understanding the ultrasound characteristics of malignant PCTNs is important to make a precise diagnosis of thyroid nodules.
确定超声（US）下部分囊性甲状腺结节（PCTN）恶性的相关因素。
这是一项回顾性研究，共纳入 338 例经手术证实的 PCTN。回顾性分析结节的 US 特征，并分析其在鉴别诊断中的意义。
在 338 个 PCTN 中，恶性结节 50 个，良性结节 288 个。单因素分析显示，纵横比>1、边缘呈分叶或细毛刺状与恶性显著相关，而海绵状、类圆形或椭圆形、边缘光滑与良性显著相关。在结节的内部实性部分方面，偏心性、非光滑边缘、低回声和微钙化在恶性结节中较良性结节更为常见。多因素 logistic 回归分析显示，纵横比>1（OR：13.357；95%CI：3.457-28.797）是恶性的最强独立预测因素，其次是微钙化（OR：11.578；95%CI：3.142-29.563）、边缘呈分叶或细毛刺状（OR：6.331；95%CI：1.425-9.457）、偏心性（OR：5.456；95%CI：1.358-8.774）、内部实性部分的非光滑边缘（OR：4.897；95%CI：0.754-7.021）和内部实性部分的低回声（OR：4.651；95%CI：0.712-8.245）。
了解恶性 PCTN 的超声特征对于甲状腺结节的准确诊断很重要。
