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ABSTRACT Objective: To determine sonographic features of malignancy in partially cystic thyroid nodules and assess the diagnostic efficacy of these features for differentiating between benign and malignant lesions in the nodules with indeterminate cytology. Subjects and methods: From January 2016 to December 2017, a total of 91 patients with 94 partially cystic thyroid nodules who had undergone ultrasound-guided fine-needle aspiration biopsy and thyroid surgery in our hospital were included in this study. The sonographic features of the thyroid nodules were analyzed to identify the predictive features of malignancy and assess the diagnostic efficacy of these features. Results: The features of hypoechogenicity, microcalcification, composition, and an eccentric solid component with an acute angle had statistically significant associations with malignant nodule (p<005) by univariable analysis. Binary logistic regression analysis showed that microcalcification and hypoechogenicity were significantly associated with malignancy. Using the combination of microcalcification, hypoechogenicity, and a solid component comprising of greater than or equal to 50% of the total volume, the diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 97.6%, 32.7%, 53.9%, and 94.4%, respectively. In these nodules with indeterminate cytology, this combination also exhibited a high sensitivity of 92.3% and an NPV of 83.3%. Conclusion: This study demonstrated that microcalcification and hypoechogenicity were independently associated with malignancy in partially cystic thyroid nodules. The combination of microcalcification, hypoechogenicity, and a solid portion that is greater than or equal to 50% of the total volume will help guide clinical decisions in mixed cystic solid nodules.
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Humans , Thyroid Neoplasms/diagnostic imaging , Thyroid Nodule/diagnostic imaging , Retrospective Studies , Ultrasonography , Sensitivity and Specificity , Biopsy, Fine-NeedleABSTRACT
Objective To investigate the correlation between ultrasonographic features of papillary thyroid microcarcinoma (PTMC) and cervical lymph node metastasis.Methods We reviewed 575 PTMC pathologically confirmed after operation in Tianjin Cancer Hospital,analyzing the ultrasonographic characteristics of primary site and risk factors of cervical lymph node metastasis.Results The univariate analysis showed that diameter ＞ 5 mm,length over breadth ratio ＞ 1,multifocality,ill-defined margin,hypoechogenicity,micro-calcification,capsule invasion ＞ 1/4 perimeter of PTMC were significantly associated with cervical lymph node metastasis.Lower pole nodules were correlated with central lymph nodes metastasis.By multivariate analysis micro-calcification,capsule invasion ＞ 1/4 perimeter of PTMC were independent risk factors for cervical lymph node metastasis.Diameter ＞ 5 mm and micro-calcification were independent risk factors of skip metastasis of ipsilateral lymph nodes.Conclusions Micro-calcification,capsule invasion ＞ 1/4 perimeter of PTMC are independent risk factors for cervical lymph node metastasis in PTMC patients.
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Objective At present,the detection rate of cervical metastatic lymph nodes in patients with papillary thyroid carcinoma (PTC) is relatively low by imaging technology.The article aimed to demonstrate the ultrasonographic features of PTC in predicting cervical lymph nodes metastasis(CLNM).Methods A retrospective analysis was done on 169 PTC patients proved by surgery and pathology who underwent cervical lymph node dissection in the Department of Ultrasonography in Nanjing General Hospital of Nanjing Military Command from January 2016 to March 2017.The patients were divided into CLNM group(n=83) and non-CLNM group (n =86).Analysis was made on the related risk factors of PTC CLNM.Results Multivariate logistic regression analysis showed that age(OR=0.211,95％CI:0.078～0.571,P=0.002),nodule size (OR=3.116,95％CI:1.498～6.482,P=0.002) and shape (OR=3.000,95％CI:1.301～6.913,P=0.010) were risk factors for CLNM in PTC(P＜0.05).The sensitivity rates of patient's age,nodule shape,module size,and microcalcification for predicting CLNM in PTC patients were 91％、79％、61％、75％ respectively.Conclusion For PTC patients less than 30 years old,ultrasonographic features with maximal diameter of nodule ＞ 1 cm,irregular shape,and microcalcification have a certain predictive value on CLNM and can be used as the basis for the selection of intraoperative cervical lymph node dissection.
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Background and purpose:Breast invasive ductal carcinoma (IDC) is the most common breast carci-noma, and the ultrasonographic features of its molecular subtypes has great clinical value. The purpose of this study was to discuss the correlation between ultrasonographic features of IDC and its molecular subtypes.Methods:Ultrasonographic features of 112 patients with preoperative integrated ultrasonographic information and pathologically confirmed IDC from Sep. 2012 to Feb. 2015 were retrospectively analyzed. Based on the immunohistochemistry results of ER (estrogen receptor), PR (progesterone receptor), HER-2 (human epidermal growth factor receptor-2) and Ki-67, these cases were categorized into 4 molecular subtypes: Luminal A group, Luminal B group, ERBB2 positive group and Basal-like group. Results:There were 14 cases (12.5%) in Luminal A group, 62 cases (55.4%) in Luminal B group, 21 cases (18.7%) in ERBB2 positive group and 15 cases (13.4%) in Basal-like group. The 4 molecular subtypes differed in tumor length, lymph node involvement, tumor boundary, tumor shape and internal blood flow on ultrasonography (P0.05).Luminal A group and Luminal B group had less lymph node involvement, more obscure boundary and irregular shape. More internal blood flow, bigger tumor size and lymph node involvement were observed in ERBB2 positive group of this study. Patients in Basal-like group were more likely to have clear tumor boundary, regular tumor shape, bigger tumor size and lymph node involvement on ultrasonogram.Conclusion:Correlation exists between ultrasonographic features and molec-ular subtypes of IDC. This has tremendous clinical significance in the early diagnosis of IDC, preoperative, intraoperative and prognosis evaluation of IDC patients.
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Objective To discuss the ultrasonographic features of immunosuppressants induced hepatotoxicosis after renal allograft. Methods The pre operative and postoperative ultrasonographic features of liver and gallbladder (GB) of 29 renal transplantation patients with clinical hepatotoxicity, after the use of CsA as the main immunosuppressive agent, were evaluated. Results Out of the 29 patients, 23 exhibited enhanced liver echo and 6 patients had features of fatty liver. The thickness of gallbladder wall was around 0.3cm in 21 patients. The morbidity rate of hepatotoxicity was 69% (20/29) in three months. Conclusion The main ultrasonographic features of immunosuppresive agent induced hepatotoxicity were enhanced liver echo, thickened gallbladder wall and unclear echo from GB. These findings provided important subsidiary diagnostic signs for hepatotoxicosis, especially three months after renal allograft. At this time, not only the allograft renal should be examined, but also the liver and gallbladder should be scrutinized with ultrasound. The ultrasonographic changes together with the clinical laboratory data could serve as a guidance for the administration of immunosuppressive drugs.