|
US Diagnosis for Thyroid Nodules with an Indeterminate
Cytology |
|
Jong Geun Ha, MD1, Dong Wook Kim, MD1, Tae Woo Kang, MD2 |
|
1Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan,
Korea
2Department of General Surgery, Saegyaero Hospital, Busan, Korea |
|
Purpose: We wanted to assess the diagnostic efficacy of thyroid ultrasound (US)
for evaluating thyroid nodules with indeterminate cytology.
Materials and Methods: Among 1865 nodules in 1278 patients who received a
prospective US diagnosis of their thyroid nodule(s) and who subsequently underwent
US-guided fine-needle aspiration, 130 nodules with indeterminate cytology were
enrolled in the study. Each thyroid nodule was prospectively classified by a single radiologist
into 1 of 5 diagnostic categories: “benign”, “probably benign”, “indeterminate”,
“suspicious for malignancy” and “malignant.” The solid nodules were classified using
all 5 categories and the partially cystic nodules classified using 4 categories (“indeterminate”
was omitted). We calculated the diagnostic efficacy of thyroid US by comparing
the US diagnoses with the pathology results.
Results: Of 130 nodules with indeterminate cytology (130/1865, 7.0%), 62 nodules
were surgically removed. Nineteen nodules were assigned to the indeterminate category
on US. The malignantly rate of the US-indeterminate category was 56.5%
(35/62). The sensitivity, specificity and positive and negative predictive values were
81.0%, 81.8%, 81.0%, 81.8% and 81.4%, respectively, when US-indeterminate nodules
were excluded. There was no significant difference of diagnostic efficacy when
these nodules were reclassified as malignant, but there was a significant difference of
diagnostic efficacy when these nodules were reclassified as benign.
Conclusion: Our US classification may be a feasible method for managing thyroid
nodules with indeterminate cytology. |
|
Keyword : Thyroid nodule; Ultrasound; Fine-needle aspiration; Indeterminate; |
|
pdf파일 : 179-185하종근.pdf
|
|