Objective To evaluate the role of ultrasound for thyroid nodules with atypia of undetermined significance(AUS).Methods From January 2014 to December 2015,83 thyroid nodules with AUS diagnosed by ultrasound-guided fine-needle aspiration biopsy were collected from 1984 subjects. On the basis of ultrasonic features,each thyroid nodule was prospectively classified into one of three categories: low suspicion for malignancy,intermediate suspicion for malignancy,and high suspicion for malignancy. Results Among 83 lesions,19 lesions(22.9%) were confirmed malignant,8 lesions (9.6%)were benign,56 lesions (67.5%)had no abnormal changes during clinical follow-up. The nodules were solitary in 36 cases (43.4%)and multiple in 47 cases(56.6%).The maximum diameter was (1.2±0.7)cm. Based on the ultrasonic feature of 19 malignant cases,16 cases (84.2%) were classified as high suspicion for malignancy,2 cases(10.5%) as intermediate suspicion for malignancy,and 1 case(5.3%) for low suspicion for malignancy. Univariate and multivariate analyses revealed that the degree of malignancy of thyroid nodules was significantly associated with ultrasound image classification[OR=9.23(2.96-28.79),P=0.00],but not with age,gender,nodule number,and nodule size (all P>0.05).Conclusion Ultrasound diagnosis by using the present thyroid ultrasound classification system can be helpful for distinguishing malignant and benign AUS thyroid nodules.
Biopsy, Fine-Needle ; Humans ; Thyroid Gland ; diagnostic imaging ; Thyroid Neoplasms ; diagnostic imaging ; Thyroid Nodule ; diagnostic imaging ; Ultrasonography

The prevalence of thyroid nodules in population is increasing around the world.To categorize thyroid nodules and stratify their malignant risk, thyroid imaging reporting and data system(TIRADS)was developed 6 years ago based on US , which is similar to breast imaging reporting and data system (BI-RADS). This paper aims at summarizing the particular content of kinds of TIRADS proposed by different researcher, clinic value of the application of TIRADS, the research status of TIRADS application, as well as the prospect of TIRADS based on CT and MRI.
Diagnostic Imaging ; Humans ; Prevalence ; Registries ; Risk Assessment ; Thyroid Nodule ; diagnosis

OBJECTIVETo evaluate the value of contrast-enhanced ultrasound (CEUS) in diagnosing thyroid nodules coexisting with Hashimoto's thyroiditis (HT).

METHODSTotally 62 thyroid nodules in 48 HT patients were retrospectively analyzed. The CEUS characteristics were reviewed, and diagnostic value of enhancement pattern and peak intensity were calculated.

RESULTSPeak intensity (P=0.002) and enhancement pattern (P<0.001) differed significantly between malignant and benign thyroid nodules. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of heterogeneous enhancement were 97.6%, 85.7%, 93.0%, 94.7%, and 93.5%, respectively. Sensitivity, specificity, PPV, NPV and accuracy of low intensity at peak time were 85.4%, 52.4%, 77.8%, 64.7%, and 74.2%, respectively.

CONCLUSIONSHeterogeneous enhancement is effective in the diagnosis of malignant thyroid nodules coexisting with HT. CEUS can improve the diagnostic accuracy in distinguishing thyroid nodules with unknown malignancy under the conventional ultrasound.

Biopsy, Fine-Needle ; methods ; Humans ; Thyroid Nodule ; diagnostic imaging ; Ultrasonography

OBJECTIVETo evaluate the application value of preoperative ultrasound-guided drawing for locating thyroid micronodule in surgery.

METHODSA total of 88 patients (with 137 thyroid micronodules) who underwent thyroid surgery was included in the prospective study. Preoperative thyroid ultrasound was conducted in all patients. Select criteria: the maximum diameter of nodule ≤ 1 cm. All patients were randomly divided into two groups: 46 patients (68 micronoduls) in experimental group with ultrasound-guided drawing location of thyroid micronodule and 42 patients (69 micronoduls) in control group without ultrasound-guided drawing location of thyroid micronodule.

RESULTSAll thyroid micronodules of experimental group were found quickly and accurately in surgery, and 4 micronodules in 4 patients of control group were not found in surgery. US examinations 3 months after surgery showed that all micronodules in experimental group were completely removed and 4 micronodules in control group retained.

CONCLUSIONUltrasound-guided drawing is a useful technique for locating and searching accurately thyroid micronodule in surgery.

Around 50% of the population harbour thyroid nodules on ultrasonography, up to 7% of which may be malignant irrespective of size. While fine-needle aspiration biopsy is reliable, subjecting every thyroid nodule to this procedure is not cost-effective. Hence, ultrasonography is used primarily to characterise thyroid nodules, whereas nodules that have suspicious features are subject to a fine-needle aspiration biopsy. The presence of microcalcifications, macrocalcifications, irregular margins, 'taller-than-wide' shape, marked hypoechogenicity and intrinsic vascularity are features that render a thyroid nodule suspicious for malignancy. Spongiform appearance and the presence of colloid plugs or purely cystic nodules are considered features of benignity. In this article, these aforementioned sonographic features of malignancy and benignity are pictorially illustrated and a basic approach to dealing with solitary and multiple thyroid nodules is highlighted.
Humans ; Predictive Value of Tests ; Thyroid Neoplasms ; diagnosis ; diagnostic imaging ; Thyroid Nodule ; diagnosis ; diagnostic imaging ; Ultrasonography

Diagnostic Errors ; Female ; Humans ; Middle Aged ; Thyroid Nodule ; diagnostic imaging ; Ultrasonography ; Zenker Diverticulum ; diagnostic imaging

OBJECTIVETo investigate the diagnostic value of ultrasonography for diffuse thyroid disease accompanied with suspicious nodules.

METHODSA total of 148 patients with diffuse thyroid diseases accompanied with suspicious nodules underwent both ultrasonography and ultrasound-guided biopsy, and the results were analyzed and compared.

RESULTSAmong these 148 patients, 44 had Hashimoto's thyroiditis and 104 had Graves'disease. Totally 151 suspicious lesions were detected by ultrasonography, among which 48 lesions were pathologically confirmed to be benign and 103 malignant. Thirteen malignant lesions were diagnosed as benign by pre-operative ultrasonography, which were confirmed to be malignant after the surgical resection due to other suspected or confirmed malignant lesions. The detection rate of diffuse thyroid disease accompanied with thyroid cancer by per-operative ultrasound was 68.21%, and the misdiagnosis rate was 31.79%. The gender of patients(P=0.36), number of nodules(P=0.08), and blood flow types in lesions(P=0.080) had no significant difference between the benign and malignant groups, whereas internal echo(P=0.040), margin(P=0.000), shape(P=0.001), and calcification features(P=0.000)showed significant differences. Up to 80.74% of the lesions with hyperechoic calcification were malignant.

CONCLUSIONSGray-scale sonographic features are helpful for the differential diagnosis of nodules in patients with diffuse thyroid diseases. Nodules in the isthmus and those accompanied with multiple nodules should be noticed.

Carcinoma, Papillary/diagnostic imaging* ; Humans ; Retrospective Studies ; Thyroid Cancer, Papillary/diagnostic imaging* ; Thyroid Neoplasms/diagnostic imaging* ; Thyroid Nodule/diagnostic imaging* ; Ultrasonography

Objective: To analyze the features of degenerating cystic thyroid nodules (DCTN) on conventional ultrasound and contrast-enhanced ultrasound (CEUS), and to explore the differentiation between DCTN and papillary thyroid carcinomas (PTC). Methods: A total of 46 DCTN (39 cases, including 12 males and 27 females, with an age range of 25 to 76 years) and 36 PTC (32 cases, including 8 males and 24 females, with an age range of 23 to 68 years) diagnosed via fine- needle aspiration (FNA) or surgery from February 2019 to January 2020 in the First Affiliated Hospital of Nanchang University were enrolled. The size, shape, margin, echogenicity, presence of shadowing, calcification and vascularity of DCTN and PTC were retrospectively evaluated, and 28 DCTN and 30 PTC underwent CEUS were separately analyzed and compared.The t test, χ² test or Fisher's exact test were implemented to compare the features of ultrasound among the two groups. The binary Logistic regression test was performed to determine whether the feature whose difference was statistically significant was an independent predictive risk factor. Results: A univariate analysis indicated that DCTN more frequently showed wider-than-tall shapes, marked hypoechogenicity, well-defined margin and no or dot-lined enhancement (wider-than-tall shapes: 36 vs. 17, χ²=8.511; well-defined margin: 30 vs. 15, χ²=4.523; marked hypoechogenicity: 27 vs. 9, χ²=9.310; no or dot-lined enhancement: 24 vs. 3, χ²=33.369; all P＜0.05). A multivariate analysis demonstrated that wider-than-tall shapes, well-defined margin and marked hypoechogenicity were independent predictors for DCTN (OR values were 5.204, 3.134 and 5.042, P values were 0.003, 0.031, and 0.003, respectively). Among 28 DCTN, 15 showed a decrease in mean maximum diameter (24.3±11.4 mm) with a mean time span of (18.6±10.5) months between the presence and absence of suspicious ultrasound features. Conclusions: Compared with PTC, DCTN shows the ultrasound characteristics of wider-than-tall shapes, well-defined margin, marked hypoechogenicity and no or dot-lined enhancement pattern. Ultrasound follow-up can help to identify spontaneous DCTN.
Adult ; Aged ; Carcinoma, Papillary/diagnostic imaging* ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Cancer, Papillary/diagnostic imaging* ; Thyroid Neoplasms/diagnostic imaging* ; Thyroid Nodule/diagnostic imaging* ; Ultrasonography