Abstract：Objective To analyze ultrasound imaging characteristics of thyroid nodules with the relative importance of these features in predicting risk for malignancy. Methods 933 patients underwent thyroid ultrasound imaging and thyroid nodule resection from June 2012 to September 2014 in Renmin Hosptial of Wuhan University were retrospectively analyzed. 1362 resected nodules were divided into benign group (n=1022) and thyroid cancer group (n=340) according to the histopathological examination results. Ultrasound results of each nodule were analyzed, the difference between two groups was compared. Risk factors of thyroid cancer screening were analyzed by Logistic regression. Results Ultrasound nodule characteristics of tumor size, boundary, calcification type, aspect ratio, blood flow signal, echo image and cervical lymph node enlargement and other imaging characteristics between benign group and thyroid cancer group were compared, with statistical differences (P ＜ 0.05). For hypoechoic nodules following four ultrasound nodule characteristics were considered to be the only findings associated with the risk of thyroid cancer: microcalcifications (OR=27.954, 95%CI=18.119-43.128, P < 0.01), central vascularity (OR=5.841, 95%CI=4.162-8.197, P < 0.01), ill defined or spiculated margins (OR=3.034, 95%CI=2.227-4.135, P < 0.01) and cervical lymphadenopathy (OR=22.981, 95%CI=13.045-40.483, P < 0.01). Grade Ⅰ was defined as none of abnormal ultrasound imaging characteristic and the risk of cancer was less than 20%. Grade Ⅱ was defined as 1 characteristic was used as an indication for ultrasound except microcalcifications, the risk of cancer was 20%-<50%.Grade Ⅲ was defined as 2 characteristics were required for ultrasound imaging included only had microcalcifications, the risk of cancer was 50%-80%. And grade Ⅳ was defined as 3 or more suggestive ultrasound characteristics were contained, the risk of cancer was more than 80%. Conclusion Thyroid ultrasound imaging can be used to identify patients who have a low risk of cancer to reduce unnecessary and excessive treatment and biopsy.
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2017, Vol. 14 
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