The Detection Rate and Influencing Factors of TI-RADS Grade 4 Nodules ≤1 cm in the Diagnosis of Suspected Malignant Calcifications via Ultrasound-Guided Fine Needle Aspiration
WANG Dong
Department of Thyroid Surgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou Henan 450000
Abstract：【Objective】To investigate the detection rate of grade 4 nodules within 1 cm and the influencing factors in the diagnosis of suspected malignant calcification by ultrason-guided thyroid fine needle puncture in the Thyroid Imaging Reporting and Data System (TI-RADS).【Methods】A total of 213 cases of TI-RADS grade 4 patients with small nodules less than 1 cm were prospectively selected in our hospital from January 2020 to December 2023. All of them underwent ultrasound-guided thyroid fine needle puncture diagnosis, and the postoperative histopathological examination results were used as the gold standard. The diagnostic value of ultrasound-guided thyroid fine needle puncture in the small nodules within 1 cm of grade 4 TI-RADS was analyzed, and the influencing factors of the accuracy of ultrasound-guided thyroid fine needle puncture in diagnosing the small nodules within 1 cm of grade 4 TI-RADS were analyzed.【Results】Postoperative pathological diagnosis showed that 184 cases were malignant nodules and 29 cases were benign nodules. Ultrasound-guided thyroid fine needle puncture was used to diagnose grade 4 small nodules within 1 cm of TI-RADS accurately in 192 cases, and under-diagnosed in 21 cases. The sensitivity, specificity and accuracy of ultrasus-guided thyroid fine needle puncture in diagnosing the benign and malignant nodules within 1 cm of grade 4 TI-RADS were 88.59%, 100.00% and 90.14%, respectively. Logistic regression analysis showed that the maximum nodule diameter, nodule composition, calcification, and blood supply were the influencing factors for the accuracy of ultrasound-guided thyroid fine needle puncture in diagnosing small nodules within 1 cm of grade 4 TI-RADS (P<0.05).【Conclusion】The risk of malignant nodules within 1 cm of grade 4 TI-RADS with suspected malignant calcification is higher. The maximum diameter of nodules, nodule composition, calcification and blood supply are the factors influencing the accuracy of diagnosing the benign and malignant nodules within 1 cm of grade 4 TI-RADS with ultrasound-guided thyroid fine needle puncture.
王栋. 超声引导下甲状腺细针穿刺诊断可疑恶性钙化灶TI-RADS 4级1 cm以内小结节的检出率及影响因素[J]. 医学临床研究, 2025, 42(2): 235-238.
WANG Dong. The Detection Rate and Influencing Factors of TI-RADS Grade 4 Nodules ≤1 cm in the Diagnosis of Suspected Malignant Calcifications via Ultrasound-Guided Fine Needle Aspiration. JOURNAL OF CLINICAL RESEARCH, 2025, 42(2): 235-238.
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2025, Vol. 42 
