超声波特征在预测甲状腺恶性瘤中的可靠性
Sushmitha D J1, Rahul A V2, Kiran Shankar1
1Surgical Oncology, Cauvery Heart and Multi-Speciality Hospital, Mysuru, IND.
Cureus
|October 20, 2025
概括
一个五个特征的超声波 (US) 复合规则显示出高灵敏度检测恶性甲状腺结节,有助于查. 结合不规则的利和微化,为风险分层提供了一个平衡的方法.
科学领域:
- 放射学和成像学 放射学和成像学
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
背景情况:
- 甲状腺结节的发病率越来越高,需要准确的诊断工具.
- 超声波 (美国) 是甲状腺结节的首选初步检查,原因是安全性和可访问性.
- 精细针吸收活检 (FNAB) 是一种侵入性和昂贵的方法,伴有相关风险.
研究的目的:
- 为了评估预先定义的五个特征超声组合的诊断准确性,用于识别恶性甲状腺结节.
- 为了比较美国复合的敏感性,特异性,正预测值 (PPV),负预测值 (NPV) 和AUC与病原学.
- 通过ROC分析,确定美国特征的最佳组合,以提高诊断性能.
主要方法:
- 313名患有甲状腺结节的患者进行了查;146人接受了手术.
- 进行了手术前超声波 (US) 和细针吸入细胞学 (FNAC).
- 通过比较美国特征 (低可热性,不规则的边缘,微化,增加的血管性,可疑的淋巴结) 和FNAC结果与手术切除的结节的组织病理学来评估诊断准确性. 使用了≥2个积极的美国特征的规则.
主要成果:
- 五个特征的美国复合规则将112名患者归类为阳性,其中84名确诊恶性瘤.
- 该规则显示灵敏度为95.45%,特异性为51%,PPV为75%.
- ROC分析表明,不规则边缘和微化的组合产生了对恶性瘤的平衡敏感度 (74.4%) 和特异性 (73.5%).
结论:
- ≥2特征超声组合规则对查恶性甲状腺结节具有很高的敏感性.
- 不规则边缘和微化的组合提供了更平衡的诊断权衡,适合风险分层.
- 综合US,细胞学和临床因素的多学科评估对于最终的管理决策至关重要.
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