Values of coarse calcification ultrasound feature for differential diagnosis of benign and malignant thyroid nodules and C-TIRADS classification
10.3760/cma.j.cn115355-20240923-00445
- VernacularTitle:粗大钙化超声特征对甲状腺结节良恶性鉴别诊断及C-TIRADS分类的价值
- Author:
Le REN
1
;
Gaiqin XUE
Author Information
1. 山西医科大学医学影像学院，太原 030001
- Publication Type:Journal Article
- Keywords:
Thyroid nodules;
Ultrasound examination;
Coarse calcification;
Chinese Thyroid Imaging Reporting and Data System
- From:
Cancer Research and Clinic
2025;37(2):138-142
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of coarse calcification ultrasound feature for the differential diagnosis of benign and malignant thyroid nodules and the China Thyroid Imaging Reporting and Data System (C-TIRADS) classification.Methods:A retrospective case series study was conducted. Two hundred and twenty solid thyroid nodules with coarse calcification confirmed by surgical pathology in 210 patients from January 2023 to February 2024 in Shanxi Province Cancer Hospital were selected. Using the postoperative pathological results as the gold standard, the nodules were divided into benign and malignant groups, and the ultrasound characteristics and specific features of coarse calcification of the nodules were compared between the two groups. Binary logistic regression analysis was used to screen for independent predictors of nodal malignancy in the coarse calcification features, and the independent predictors were assigned scores based on the C-TIRADS classification. The efficacy of C-TIRADS classification combined with independent predictors of nodal malignancy in the coarse calcification features for diagnosing malignant nodules was analyzed using receiver operating characteristic (ROC) curve.Results:The postoperative pathological findings of 220 thyroid nodules showed 70 (31.82%) were benign and 150 (68.18%) were malignant. The echogenicity, maximum diameter, orientation, margins of nodules and the location, number, promiscuity, peripheral soft tissue shadow of coarse calcification were compared between the benign and malignant groups, and the differences were statistically significant (all P < 0.05). Logistic regression analysis showed that the presence of coarse and irregular calcification ( OR = 7.20, 95% CI: 3.16-16.37, P < 0.001) and coarse calcification with peripheral soft tissue shadow ( OR = 7.87, 95% CI: 3.74-16.57, P < 0.001) were independent predictors for nodule malignancy. The area under the curve (AUC), sensitivity, specificity, and accuracy for diagnosing malignant nodules by C-TIRADS classification were 0.75, 66.67%, 81.43%, and 71.36%, respectively; the AUC, sensitivity, specificity, and accuracy for diagnosing malignant nodules by C-TIRADS classification combined with coarse and irregular calcification and peripheral soft tissue shadow were 0.88, 84.00%, 80.00%, and 82.73%, respectively; the difference in AUC for diagnosing malignant nodules with C-TIRADS classification alone and in combination with coarse calcification features was statistically significant ( Z = 4.69, P < 0.001). Conclusions:Coarse and irregular calcification and peripheral soft tissue shadow are risk factors for malignancy of thyroid nodules, and the diagnostic accuracy of the two in combination with C-TIRADS classification is high.
