Size and Ultrasound Features Affecting Results of Ultrasound-Guided Fine-Needle Aspiration of Thyroid Nodules

作者：Dong, YiJie; Mao, MinJing; Zhan, WeiWei^*; Zhou, JianQiao; Zhou, Wei; Yao, JieJie; Hu, YunYun; Wang, Yan; Ye, TingJun

来源：Journal of Ultrasound in Medicine, 2018, 37(6): 1367-1377.

DOI：10.1002/jum.14472

• false negative
• false positive
• size
• thyroid nodules
• thyroid
• parathyroid
• ultrasound features
• ultrasound-guided fine-needle aspiration

ObjectivesOur goal was to assess the diagnostic efficacy of ultrasound (US)-guided fine-needle aspiration (FNA) of thyroid nodules according to size and US features. @@@ MethodsA retrospective correlation was made with 1745 whole thyroidectomy and hemithyroidectomy specimens with preoperative US-guided FNA results. All cases were divided into 5 groups according to nodule size (5, 5.1-10, 10.1-15, 15.1-20, and >20mm). For target nodules, static images and cine clips of conventional US and color Doppler were obtained. Ultrasound images were reviewed and evaluated by two radiologists with at least 5 years US working experience without knowing the results of pathology, and then agreement was achieved. @@@ ResultsThe Bethesda category I rate was higher in nodules larger than 15mm (P<.05). The diagnostic accuracy was best in nodules of 5 to 10mm in diameter. The sensitivity, accuracy, PPV, and LR for negative US-guided FNA results were better in nodules with a size range of 5 to 15mm. The specificity, negative predictive value (NPV), and LR for positive results and the Youden index rose with increasing nodule size. Seventeen false-positive and 60 false-negative results were found in this study. The false-negative rate rose with increasing nodule size. However, the false-positive rate was highest in the group containing the smallest nodules. Nodules with circumscribed margins and those that were nonsolid and nonhypoechoic and had no microcalcifications correlated with Bethesda I FNA results. Nodules with circumscribed margins and those that were nonsolid, heterogeneous, and nonhypoechoic and had increased vascularity correlated with false-negative FNA results. Borders correlated with Bethesda I false-negative and false-positive FNA results. @@@ ConclusionsTiny nodules (5mm) with obscure borders tended to yield false-positive FNA results. Large nodules (>20mm) with several US features tended to yield false-negative FNA results.

• 出版日期2018-6
• 单位上海市闵行区中心医院; 上海交通大学