|
|
|
| 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.
|
|
Received: 11 May 2024
|
|
|
|
|
|
[1] 李劲松,田秀丽. 超声造影联合细针穿刺活检对TI-RADS 4类甲状腺结节的诊断及结节性质与FPG、HbA1c水平的相关性分析[J].医学临床研究,2024,41(9):1319-1321.
[2] 宋亚妮,杨志军. 富血供及乏血供甲状腺结节在超声引导下行US-FNAB时穿刺针口径选择的研究[J].医学临床研究,2023,40(10):1478-1481.
[3] 黄锋华. B超引导下细针穿刺诊断甲状腺小结节的特异性及灵敏度分析[J].养生保健指南,2023(12):223-225.
[4] TESSLER F N, MIDDLETON W D, GRANT E G. Thyroid Imaging Reporting and Data System (TI-RADS): A User's Guide[J].Radiology,2018, 287(1):29-36.
[5] ALI S Z, BALOCH Z W, COCHAND-PRIOLLET B, et al. The 2023 bethesda system for reporting thyroid cytopathology[J].Thyroid,2023, 33(9):1039-1044.
[6] 张岱,杨凡,王莹,等. 不同大小甲状腺髓样癌与甲状腺乳头状癌的超声特征比较[J].中华肿瘤杂志,2024,46(2):133-139.
[7] 邵芸青,蔡鹏飞. 超声弹性成像联合细针穿刺细胞学诊断甲状腺良恶性结节的价值[J].影像研究与医学应用,2024,8(15):83-85.
[8] 赵玲,马步云. 甲状腺髓样癌和甲状腺乳头状癌的超声特征研究[J].现代肿瘤医学,2023,31(16):3010-3014.
[9] 翁赟婷,范义,徐蕾,等. 实时超声弹性成像技术鉴别诊断甲状腺小结节的应用价值[J].浙江医学,2023,45(23):2549-2551.
[10] 陈敏. 甲状腺小结节的高频彩超影像学特征及与术后病理的一致性分析[J].影像研究与医学应用,2023,7(15):168-170.
[11] 牟静,刘家开,徐可,等. 剪切波弹性成像杨氏模量最大值联合甲状腺影像报告和数据系统对甲状腺小结节诊断价值分析[J].中国医学装备,2023,20(5):109-113.
[12] 邸小夏. 超声引导下甲状腺结节细针穿刺细胞学诊断准确度的影响因素[D]. 河北:河北医科大学,2021.
[13] 陈曦,陶玲玲,詹维伟,等. 超声引导下细针穿刺抽吸甲状腺结节标本质量的影响因素[J].中国介入影像与治疗学,2022,19(8):463-466.
[14] 程将,葛晖. 超声引导下甲状腺小结节细针穿刺标本无法诊断的影响因素[J].中华医学超声杂志(电子版),2021,18(11):1049-1053. |
|
|
|
2025, Vol. 42 
