带有光环的甲状腺结节的声像图特征。

IF 1.9 Q3 ENDOCRINOLOGY & METABOLISM
Danming Cao, Rong Zou, Ming Zhang, Kui Tang
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引用次数: 0

摘要

目的研究甲状腺结节伴晕的声像图特征,探讨造影剂增强超声(CEUS)联合细针穿刺(FNA)在识别甲状腺结节伴晕中的价值,并通过分析晕的病理特征预测转移风险:方法:对2019年1月至2022年12月期间185例甲状腺结节术后伴有光环的病例进行回顾性分析。在描述甲状腺结节及其光晕的超声特征后,将所有患者分为三组,第一组(Ⅰ组=仅CEUS)患者进行CEUS检查,第二组(Ⅱ组=CEUS+FNA)在第一组的基础上进行FNA检查,第三组(Ⅲ组=仅FNA)直接进行FNA检查。CEUS和FNA结果分别采用中国甲状腺影像报告和数据系统(C-TIRADS)和贝塞斯达甲状腺细胞病理学报告系统进行分级。分级低于 C-TIRADS 4b 或 Bethesda IV 级者定义为良性,两种方法合并时参考 FNA 的结果。手术病理结果作为金标准。我们绘制了工作曲线,以比较 CEUS 和 FNA 单独或联合诊断甲状腺结节光环的疗效。我们分析了光环的病理特征,并记录了有颈淋巴结转移的患者人数:结果:160 名患者符合要求。良性结节的主要特征是光环较薄(0.75±0.31 毫米)且均匀一致,完整性良好,而恶性结节的光环较厚(1.48±0.51 毫米),边缘不均匀且不规则(P 结论:良性结节的光环较薄,边缘不均匀且不规则,而恶性结节的光环较厚(1.48±0.51 毫米),边缘不均匀且不规则:恶性甲状腺结节周围的光环较厚,边缘不均匀且不规则,在CEUS上显示低增强。将 CEUS 与 FNA 结合使用可提高甲状腺结节光环的诊断效果。反应性增生纤维晕可能是恶性结节不易转移的原因之一。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Sonographic characteristics of thyroid nodules with a Halo.

Objective: To investigate the sonographic characteristics of thyroid nodules with a halo, explore the value of contrast-enhanced ultrasound (CEUS) combined with fine needle aspiration (FNA) in identifying nodules with a halo, and predict the risk of metastasis by analyzing the pathological features of the halo.

Methods: A retrospective analysis was conducted on 185 postoperative cases of thyroid nodules accompanied by halos between January 2019 and December 2022. After describing the ultrasound characteristics of the thyroid nodules and their halos, all patients were divided into three groups, the first group (group I = CEUS only) of patients underwent CEUS, the second group (group II = CEUS + FNA) underwent FNA based on the first group, and the third group (group III = FNA only) underwent FNA directly. The CEUS and FNA results were graded using the Chinese Thyroid Imaging Report and Data System (C-TIRADS) and Bethesda Reporting System for Thyroid Cytopathology, respectively. Those graded below C-TIRADS 4b or Bethesda IV were defined as benign, and the results of FNA were referenced when the two methods were combined. The surgical pathology results were used as the gold standard. We plotted working curves to compare the diagnostic efficacy of CEUS and FNA alone and in combination in the diagnosis of thyroid nodules with halos. The pathological features of the halo were analyzed and the number of patients with cervical lymph node metastases was recorded.

Results: One hundred and sixty patients met the requirements. Benign nodules were mainly characterized by a thin (0.75 ± 0.31 mm) and uniform halo with good integrity, while malignant nodules had a thicker (1.48 ± 0.51 mm) halo with uneven and irregular margins (P < 0.05). The sensitivity and specificity were highest when the cutoff value was 1.09 mm, with 76.08% and 84.29%, respectively. The halos of benign nodules were mostly hyper- or iso-enhanced, whereas the halos of malignant nodules were predominantly hypo-enhanced (P < 0.05). The areas under the curve (AUCs) for CEUS, FNA, and CEUS + FNA were 0.751(95% CI = 0.642-0.841), 0.863(95% CI = 0.767-0.929), and 0.918(95% CI = 0.834-0.967), respectively. Cervical lymph node metastasis occurred in only 13 (11.5%) malignant nodes with halos. The primary pathological components of the halo around malignant nodules were almost reactive hyperplastic fibrous tissue.

Conclusion: The halo surrounding malignant thyroid nodules is thicker, with uneven and irregular margins, and shows hypo-enhancement on CEUS. Combining CEUS with FNA improves the diagnostic efficacy of thyroid nodules with halos. The reactive hyperplastic fibrous halo may be one of the reasons why malignant nodules are less likely to metastasize.

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来源期刊
Thyroid Research
Thyroid Research Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
3.10
自引率
4.50%
发文量
21
审稿时长
8 weeks
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