Department of Radiology and Center for Imaging Science, Thyroid Center, 36626Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Pathology, Thyroid Center, 36626Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Acta Radiol. 2021 Apr;62(4):474-482. doi: 10.1177/0284185120929699. Epub 2020 Jun 3.
Few studies have categorized ultrasound (US) findings of various sized medullary thyroid carcinomas (MTCs) according to updated guidelines.
To evaluate and compare the differences in US findings of MTC according to nodule size, using the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and American Thyroid Association (ATA) guidelines.
The study included 119 patients with 129 MTC nodules, which were surgically confirmed at our institution between March 1999 and September 2017. Nodules were divided into large (≥1.0 cm) and small (<1.0 cm) groups. US images were analyzed according to the K-TIRADS and ATA guidelines. The differences in US characteristics between small and large nodules were compared using Fisher's exact or Chi-square tests.
Of 129 MTC nodules, 84 (65.1%) were large nodules and 45 (34.9%) were small nodules. According to the nodule size, small MTC nodules were classified more commonly as high suspicion by K-TIRADS and ATA (95.6% and 93.3%, respectively) ( < 0.001), but presented neither cystic change, isoechogenicity, nor low suspicion category by K-TIRADS and ATA. In contrast, large MTC nodules showed more frequently cystic change (15.5%), isoechogenicity (16.7%), smooth margins (50%), or low or intermediate suspicion US features by K-TIRADS and ATA (59.6% and 36.0%, respectively) (all values < 0.001).
Most small MTC nodules are classified as high suspicion on US, whereas large MTC nodules are diagnosed more frequently as low or intermediate suspicion by K-TIRADS and ATA.
根据最新指南，很少有研究对各种大小的髓样甲状腺癌（MTC）的超声（US）表现进行分类。
使用韩国甲状腺影像报告和数据系统（K-TIRADS）和美国甲状腺协会（ATA）指南，评估并比较根据结节大小的 MTC 的 US 表现差异。
本研究纳入了 1999 年 3 月至 2017 年 9 月期间在我院手术证实的 119 例 129 个 MTC 结节患者。将结节分为大（≥1.0cm）和小（<1.0cm）组。根据 K-TIRADS 和 ATA 指南分析 US 图像。使用 Fisher 精确检验或卡方检验比较小和大结节之间的 US 特征差异。
在 129 个 MTC 结节中，84 个（65.1%）为大结节，45 个（34.9%）为小结节。根据结节大小，小 MTC 结节通过 K-TIRADS 和 ATA 分类更常见为高度可疑（分别为 95.6%和 93.3%）（<0.001），但 K-TIRADS 和 ATA 未见囊性变、等回声或低度可疑类别。相比之下，大 MTC 结节更常出现囊性变（15.5%）、等回声（16.7%）、边缘光滑（50%）或 K-TIRADS 和 ATA 的低度或中度可疑 US 特征（分别为 59.6%和 36.0%）（所有 P 值均<0.001）。
大多数小 MTC 结节在 US 上被归类为高度可疑，而大 MTC 结节更常被 K-TIRADS 和 ATA 诊断为低度或中度可疑。
