甲状腺体检查:检测甲状腺结节的准确性和额外发现的频率
Cristian Soto Jacome1, Andrea Garcia2, Elizabeth Golembiewski2
1Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota; Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
概括
甲状腺物理检查在检测甲状腺结节时的准确性较低,往往导致不必要的超声波. 建议重新评估常规使用甲状腺触摸,以获得更好的患者护理.
科学领域:
- 内分泌学 在内分泌学.
- 诊断成像 诊断成像 诊断成像
- 临床检查 临床检查
背景情况:
- 甲状腺触摸是识别甲状腺异常的标准临床方法.
- 身体检查的诊断准确性和额外发现的含义需要进一步调查.
研究的目的:
- 评估身体检查的诊断准确性,以检测甲状腺结节.
- 为了评估体检后甲状腺超声波的额外发现率.
主要方法:
- 一项回顾性观察性研究分析了327名成年患者,他们在体检后进行了第一次甲状腺超声波检查.
- 评估了检测单一结节和多节结节的灵敏度,特异性,准确性和预测值.
主要成果:
- 身体检查显示灵敏度低 (20.3%单一结节,10.8%多节结节结节),但多节结节结节结节的特异性高 (96.5%).
- 单一结节的积极预测值较低 (17.6%),而多节结节的预测值较高 (73.9%).
- 在有可触摸结节的病例中,60%的超声波显示了额外的结节.
结论:
- 甲状腺体检查表明诊断性能有限.
- 这种做法经常在随后的超声波检查中产生额外的发现,从而质疑其常规效用.
- 建议提高体检准确度或重新考虑其常规使用.
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