甲状腺TI-RADS 4类结节分值及强回声灶类型与细针穿刺病理的研究

Correlation between different scores,echogenic foci and fine-needle aspiration pathology in TI-RADS 4 thyroid nodules

目的分析美国放射协会甲状腺影像报告及数据系统(ACR TI-RADS)4类结节分值、强回声灶类型与细针穿刺病理的关系,探讨其临床应用价值。方法收集TI-RADS 4类且行甲状腺细针穿刺的病例203例,将其超声评分、强回声灶类型与细针穿刺病理结果进行统计学分析。结果203例TI-RADS 4类结节中,不同分值结节的细针穿刺病理结果差异有统计学意义(χ^2=46.226,P<0.001),结节分值与穿刺Bethesda分级呈正相关(r=0.470,P<0.001);4种不同类型强回声灶结节的细胞学结果差异有统计学意义(χ^2=28.650,P<0.001),两两分析时,粗大钙化与点状强回声差异有统计学意义(χ^2=15.742,P<0.001),与大彗星尾征差异无统计学意义(χ^2=2.102,P=0.350);环状钙化与点状强回声及无或大彗星尾征间差异均无统计学意义(χ^2=2.723,P=0.256;χ^2=4.171,P=0.124)。结论对于TI-RADS 4类结节,进一步注意其分值及强回声灶特征,有助于结节良恶性的预测及临床决策的选择。

Objective To evaluate the statistical difference between thyroid imaging reporting and data system(TI-RADS)scores,echogenic foci characteristics,and fine-needle aspiration(FNA)pathology.Methods Two hundred and three TI-RADS 4 thyroid nodules that underwent FNA were collected.Then,the TI-RADS scores,echogenic foci characteristics,and pathologic results were statistically analyzed.Results Among 203 nodules with different TI-RADS scores,the pathological results were statistically different(χ^2=46.226,P<0.001),and they were positively correlated(r=0.470,P<0.001).The pathological results of different types of echogenic foci nodules were statistically different(χ^2=28.650,P<0.001).In the comparative analysis,macrocalcifications were statistically different from punctate echogenic foci(χ^2=15.742,P<0.001),but not from large comet-tail artifacts(χ^2=2.102,P=0.350).Peripheral calcifications were not statistically different to either punctate echogenic foci or large comet-tail artifacts(χ^2=2.723,P=0.256;χ^2=4.171,P=0.124).Conclusion For TI-RADS 4 thyroid nodules,more attention should be paid to its score and echogenic foci,as these can help to predict the pathology of nodules and assist in clinical decision making.