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Effect of the location and size of thyroid nodules on the diagnostic performance of ultrasound elastography: A retrospective analysis.

甲状腺结节的位置和大小对超声弹性成像诊断性能的影响: 回顾性分析。

  • 影响因子:1.35
  • DOI:10.6061/clinics/2020/e1720
  • 作者列表:"Xie X","Yu Y
  • 发表时间:2020-06-22
Abstract

OBJECTIVES:Ultrasound-guided fine-needle aspiration biopsies are recommended for the detection of suspicious thyroid nodules. However, the best approach regarding suspicious ultrasound features for thyroid nodules is still unclear. This study aimed to evaluate the effect of location and size of thyroid nodules on the diagnostic performance of strain ultrasound elastography. In addition, this study evaluated whether ultrasound elastography predicts malignancy in thyroid nodules. METHODS:Data regarding the size, depth, and distance from the carotid artery of nodules, the elasticity contrast index, and the nature of nodules were analyzed. RESULTS:There was no significant difference in the depth (p=0.092) and the distance from the carotid artery (p=0.061) between benign and suspicious nodules. Suspicious nodules were smaller than benign nodules (p<0.0001, q=23.84) and had a higher elasticity contrast index (p<0.0001, q=21.05). The depth of nodules and the size of the nodule were not associated with the correct value of the elasticity contrast index (p>0.05 for both). The diagnostic performance of ultrasound elastography was not affected by the distance of the nodules from the carotid artery if they were located ≥15 mm from the carotid artery (p=0.5960). However, if the suspicious nodules were located <15 mm from the carotid artery, the diagnostic accuracy was hampered (p=0.006). CONCLUSIONS:The strain ultrasound elastography should be carefully evaluated when small thyroid nodules are located near the carotid artery.

摘要

目的: 超声引导下细针穿刺活检被推荐用于可疑甲状腺结节的检测。然而,关于甲状腺结节可疑超声特征的最佳方法仍不清楚。本研究旨在评估甲状腺结节的位置和大小对应变超声弹性成像诊断性能的影响。此外,本研究评估了超声弹性成像是否能预测甲状腺结节的恶性程度。 方法: 分析结节的大小、深度、与颈动脉的距离、弹性对比指数以及结节的性质。 结果: 良性结节与可疑结节的深度 (p = 0.092) 和距颈动脉的距离 (p = 0.061) 差异无统计学意义。可疑结节小于良性结节 (p<0.0001,q = 23.84),弹性对比指数较高 (p<0.0001,q = 21.05)。结节的深度和大小与弹性对比指数的正确值无关 (两者p>0.05)。如果结节距颈动脉 ≥ 15毫米cm,超声弹性成像的诊断性能不受结节距颈动脉距离的影响 (p = 0.5960)。然而,如果可疑结节位于距颈动脉 <15毫米处,则诊断准确性受到阻碍 (p = 0.006)。 结论: 当甲状腺小结节位于颈动脉附近时,应仔细评估应变超声弹性成像。

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发表时间:2020-01-01
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DOI:10.1159/000496502
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影响因子:2.32
发表时间:2020-01-01
来源期刊:The Laryngoscope
DOI:10.1002/lary.27947
作者列表:["Ji T","Chen J","Mou J","Ni X","Guo Y","Zhang J","Wang S","Wang W","Zhang X","Tai J"]

METHODS:OBJECTIVES/HYPOTHESIS:The definition of large-volume pathologic N1 metastases has been changed in the 2017 version 2 of the National Comprehensive Cancer Network guidelines, leading to a controversy over the optimal surgical approach selection for patients with biopsy-proven papillary thyroid carcinoma (PTC). The aim of this study was to investigate the therapeutic efficacy of total thyroidectomy (TT) and thyroid lobectomy (TL) for these patients. STUDY DESIGN:Retrospective population-based database analysis. METHODS:A total of 906 consecutive PTC patients with pathologic N1 metastases (>5 involved nodes with metastases ≤5 mm in the largest dimension) were retrieved from the Surveillance, Epidemiology, and End Results database, and divided into two groups (≤2 mm, >2-5 mm) based on the size of the extent of disease. Overall survival (OS) was then compared between patients treated with TT and TL, followed by Cox proportional hazards regression analysis to explore multiple prognostic factors. RESULTS:OS favored TT compared with TL in patients with more than five involved nodes and metastases >2 to 5 mm in the largest dimension (P < .05). Cox analysis showed that the TL was not an independent factor associated with poorer OS than TT in these patients (P > .05). CONCLUSIONS:TT showed better survival than TL for patients with more than five involved nodes and metastases >2 to 5 mm in the largest dimension. For patients with more than five involved nodes and metastases ≤2 mm in the largest dimension, either TT or TL can be recommended because there was no difference in survival. LEVEL OF EVIDENCE:NA Laryngoscope, 130:269-273, 2020.

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影响因子:2.09
发表时间:2020-01-01
DOI:10.2174/1573399815666190417145440
作者列表:["Goes LG","da Luz Eltchechem C","Wouk J","Malfatti CRM","da Silva LA"]

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甲状腺疾病方向

主要分为内科治疗的甲状腺疾病和外科治疗的甲状腺疾病两大类。内科治疗的甲状腺疾病主要包括甲状腺功能亢进症和甲状腺炎症。外科治疗的甲状腺疾病包括甲状腺肿和甲状腺肿瘤。

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