PDF
Full
Outline
Objective To explore the consistency of ultrasonography and histopathology in diagnosis of Hashimoto thyroiditis. Methods The clinical data of 6238 patients, who underwent surgical treatment for thyroid nodules in the First Medical Center of Chinese PLA General Hospital from January 2016 to December 2020, were collected and retrospectively analyzed. The preoperative thyroid function and ultrasound examination data of the included patients were complete, and the postoperative pathological results were clear. The effectiveness of ultrasound imaging in diagnosis of Hashimoto thyroiditis was analyzed, and the consistency between ultrasound and pathological diagnosis was evaluated by use of Cohen's kappa coefficient (κ). According to the preoperative thyroid stimulating hormone (TSH) level, the patients were divided into TSH elevated group (n=329), TSH normal group (n=5662) and TSH decreased group (n=247). The diagnostic efficacy of ultrasound examination under different preoperative thyroid function states and its consistency with pathological diagnosis were discussed. Results (1) Among the 6238 patients, preoperative ultrasound examination revealed 1549 cases of Hashimoto thyroiditis, and postoperative pathological diagnosis revealed 1182 cases of Hashimoto thyroiditis; Only 687 patients (58.1%) had positive ultrasound and pathological diagnoses. Among the confirmed patients, 88.7% were women (1048/1182) and 11.3% were men (134/1182); The three typical ultrasound manifestations in women, including reduced parenchymal echo (17.9% vs. 11.8%), grid like changes (7.5% vs. 4.7%), increased blood flow (14.5%vs. 8.3%, P<0.001), as well as the positive rate of ultrasound diagnosis (27.8% vs. 17.1%, P<0.001) and pathological diagnosis (23.3%vs. 7.7%, P<0.001), were significantly higher than those in men. (2) Consistency analysis showed that the consistency between ultrasound diagnosis and pathological diagnosis was general (κ=0.367). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ultrasound diagnosis were 58.1%, 83.0%, 44.4%, 89.4% and 78.2%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of single imaging features (reduced parenchymal echo, grid like changes and increased) were 33.2%, 22.0%, 28.8%, 87.8%, 96.9%, 91.0%, 38.8%, 62.4%, 42.7% and 84.9%, 84.2%, 84.5%, respectively.The accuracy was 77.4%, 82.7% and 79.2%, respectively. Receiver operating characteristic (ROC) curve analysis showed that the predictive value of single imaging feature or the combination of two imaging features was poor in diagnosis. Among them, reduced parenchymal echo and reduced parenchymal echo combined with grid like changes were slightly better in diagnosis. (3) The positive rates of ultrasound and pathological diagnosis were higher in preoperative TSH elevated group and TSH decreased group (57.9% and 52.2% respectively in TSH elevated group; and 33.7% and 15.5% respectively in TSH decreased group, while TSH normal group was lower (22.9% and 17.7%, respectively). In addition, the consistency between ultrasound and pathological diagnosis in elevated TSH group was relatively the best, close to moderate (κ=0.399). Conclusions Both ultrasound diagnosis and single imaging features have good specificity and poor sensitivity in the diagnosis of Hashimoto thyroiditis. The consistency between ultrasound diagnosis and pathological diagnosis is general, and the consistency is slightly enhanced when combined with preoperative TSH elevation, but it can only be used as a reference. For female patients having thyroid dysfunction; the significance of combined ultrasound diagnosis will be greater. Ultrasonography is a convenient and quick supportive diagnosis of Hashimoto 's thyroiditis.
PDF
233
110
| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
关闭全屏
No. 86 Xueyuan South Road, Haidian District, Beijing
010-62199257
qkjq@cast.org.cn
Copyright © 2025 China Association for Science and Technology. All rights reserved. For all open access content, the relevant licensing terms apply.
Sponsored by the Office of the Leading Group for Cybersecurity and Informatization of CAST, and supported by Science and Technology Review Publishing House
