Sultan Salahaden R
Radiologic Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, SAU.
Cureus. 2023 May 20;15(5):e39281. doi: 10.7759/cureus.39281. eCollection 2023 May.
Thyroid nodules are commonly found on clinical examination or diagnostic imaging of the neck. Malignant thyroid nodules are increasing worldwide, making thyroid cancer one of the most common endocrine malignancies worldwide. The aim of this study was to determine B-mode ultrasound characteristics of benign thyroid nodules and nodules with risk of malignancy. Material and methods: This retrospective study was conducted on subjects (n=99) who underwent thyroid ultrasound. Data were retrieved from the Thyroid Digital Image Database of Universidad Nacional de Colombia, a published open-access dataset, in which B-mode ultrasound images were interpreted by expert radiologists providing a complete diagnostic description of thyroid lesions using the Thyroid Imaging Reporting and Data System.
Sponge-like appearance (Pearson Chi-Square 4.6, p=0.02), cystic (Pearson Chi-Square 27.3, p<0.001), isoechoic (Pearson Chi-Square 26, p<0.001), and well-defined (Pearson Chi-Square 13.7, p<0.001) thyroid nodules were more likely to be observed in benign nodules (risk of malignancy <5%). On the other hand, predominately solid (Pearson Chi-Square 5.9, p=0.01), microcalcifications (Pearson Chi-Square 50.7, p<0.001), hypoechoic (Pearson Chi-Square 27.7, p<0.001), irregular shape (Pearson Chi-Square 6.6, p=0.01), and ill-defined (Pearson Chi-Square 8.8, p=0.003) thyroid nodules were more likely to be observed in nodules with risk of malignancy (>5%).
Ultrasound characteristics could be used to determine thyroid nodules with risk of malignancy and avoid over-diagnosing nodules with benign features. Further research evaluating the use of multiparametric ultrasound to distinguish between benign thyroid nodules and thyroid nodules with risk of malignancy is required.
甲状腺结节在颈部临床检查或诊断性影像学检查中很常见。全球范围内,恶性甲状腺结节的数量正在增加,这使得甲状腺癌成为全球最常见的内分泌恶性肿瘤之一。本研究的目的是确定良性甲状腺结节和具有恶性风险的结节的B超特征。
本回顾性研究针对接受甲状腺超声检查的受试者(n = 99)开展。数据取自哥伦比亚国立大学的甲状腺数字图像数据库,这是一个已发表的开放获取数据集,其中B超图像由专家放射科医生解读,并使用甲状腺影像报告和数据系统对甲状腺病变提供完整的诊断描述。
海绵状外观(Pearson卡方检验值4.6,p = 0.02)、囊性(Pearson卡方检验值27.3,p < 0.001)、等回声(Pearson卡方检验值26,p < 0.001)以及边界清晰(Pearson卡方检验值13.7,p < 0.001)的甲状腺结节更有可能在良性结节(恶性风险<5%)中观察到。另一方面,以实性为主(Pearson卡方检验值5.9,p = 0.01)、微钙化(Pearson卡方检验值50.7,p < 0.001)、低回声(Pearson卡方检验值27.7,p < 0.001)、形状不规则(Pearson卡方检验值6.6,p = 0.01)以及边界不清(Pearson卡方检验值8.8,p = 0.003)的甲状腺结节更有可能在具有恶性风险(>5%)的结节中观察到。
超声特征可用于确定具有恶性风险的甲状腺结节,并避免对具有良性特征的结节进行过度诊断。需要进一步开展研究,评估使用多参数超声区分良性甲状腺结节和具有恶性风险的甲状腺结节的情况。