Qu Chen, Li Hong-Jian, Gao Qi, Zhang Jun-Chao, Li Wei-Min
Department of Ultrasonography, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People's Republic of China.
Department of Ultrasonography, Huai'an Cancer Hospital, Huai'an, Jiangsu, People's Republic of China.
Int J Gen Med. 2024 May 6;17:1887-1895. doi: 10.2147/IJGM.S461076. eCollection 2024.
This study aimed to investigate the alteration trends and overlaps of positive features in benign and malignant thyroid nodules of different sizes based on the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS).
1337 patients with 1558 thyroid nodules were retrospectively recruited from November 2021 to December 2023. These nodules were divided into three groups according to maximum diameter: A (≤10 mm), B (10-20 mm), and C (≥20 mm). C-TIRADS positive features were compared between benign and malignant thyroid nodules of different sizes. In addition, the trends of positive features with changes in nodule size among malignant thyroid nodules were analyzed.
The incidence of positive features in malignant thyroid nodules was higher than that in benign. As benign nodules grow, the incidence of all positive features showed a linear decreasing trend (Z values were 72.103, 101.081, 17.344, 33.909, and 129.304, P values < 0.001). With the size of malignant thyroid nodules increased, vertical orientation, solid, marked hypoechogenicity, and ill-defined/irregular margins/extrathyroidal extension showed a linear decreasing trend (Z = 148.854, 135.378, 8.590, and 69.239, respectively; P values < 0.05), while suspicious microcalcifications showed a linear increasing trend (Z = 34.699, P<0.001). In terms of overlapping characteristics, group A had a significantly higher overlapping rate than the other two groups, and the overlapping rate of solid indicators remained the highest among all three groups (P < 0.05).
Differences in positive features were observed between thyroid nodules of different sizes. Except for suspicious microcalcifications, the incidence of other four positive features decreased with increasing nodule size. In addition, a negative correlation was observed between the overlap rate and nodule size. These results may provide a basis for sonographers to upgrade or downgrade thyroid nodules based on their own experience.
本研究旨在基于中国甲状腺影像报告和数据系统（C-TIRADS），探讨不同大小的良性和恶性甲状腺结节阳性特征的变化趋势及重叠情况。
回顾性纳入2021年11月至2023年12月期间的1337例患者的1558个甲状腺结节。这些结节根据最大直径分为三组：A组（≤10 mm）、B组（10 - 20 mm）和C组（≥20 mm）。比较不同大小的良性和恶性甲状腺结节的C-TIRADS阳性特征。此外，分析恶性甲状腺结节中阳性特征随结节大小变化的趋势。
恶性甲状腺结节阳性特征的发生率高于良性结节。随着良性结节增大，所有阳性特征的发生率呈线性下降趋势（Z值分别为72.103、101.081、17.344、33.909和129.304，P值<0.001）。随着恶性甲状腺结节大小增加，垂直方向、实性、显著低回声及边界不清/不规则边缘/甲状腺外延伸呈线性下降趋势（Z值分别为148.854、135.378、8.590和69.239，P值<0.05），而可疑微钙化呈线性增加趋势（Z = 34.699，P<0.001）。在重叠特征方面，A组的重叠率显著高于其他两组，且实性指标的重叠率在三组中始终最高（P < 0.05）。
不同大小的甲状腺结节在阳性特征上存在差异。除可疑微钙化外，其他四项阳性特征的发生率随结节大小增加而降低。此外，重叠率与结节大小呈负相关。这些结果可为超声检查人员根据自身经验对甲状腺结节进行升级或降级提供依据。
