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| Differentiation of 2.0～4.0 mm benign small thyroid nodules from malignant ones by ultrasound |
| LIU Shu-yu1, GU Ying2, HAN Zhi-jiang2, WANG Yan1 |
1. Department of Ultrasound, First People’s Hospital of Hangzhou Fuyang Area, Hangzhou 311400, China;
2. First People’s Hospital of Hangzhou City, Hangzhou 310006, China |
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Abstract Objective: To investigate the diagnostic value of ultrasound for differentiating 2.0～4.0 mm benign small thyroid nodules from malignant ones. Methods: Ultrasonic data of 412 small thyroid nodules with maximum diameter of 2.0～4.0 mm, collected from 359 cases by operation and pathology, were analyzed retrospectively, including 173 cases of papillary thyroid microcarcinoma(PTMC, 194 nodules), 179 cases of micronodular goiter(MNG, 204 nodules) and 7 cases of PTMC(7 nodules) and MNG(7 nodules). Morphology, low echo, aspect ratio≥1 and distribution of micro-calcification in PTMC and MNG were observed. Results: Statistical differences were found in irregular morphology, low echo and aspect ratio≥1(χ2=261.967, P＜0.05; χ2=17.259, P＜0.05; χ2=249.703, P＜0.05) between 2.0～4.0 mm nodules of PTMC and MNG, but no difference was found in micro-calcification(χ2=1.155, P＞0.05). Aspect ratio≥1 had the highest specificity(92.9%), positive predictive value(91.9%) and accuracy(88.8%). Irregular morphology had the highest negative predictive value(94.4%). Low echo had the highest sensitivity(97.0%) and lowest specificity(14.7%). Conclusions: Irregular morphology and aspect ratio≥1 are the two important signs for differential diagnosis of 2.0～4.0 mm PTMC from MNG. Although low echo has a high sensitivity for PTMC, its low specificity limits clinical application.
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Received: 23 September 2016
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