Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Real-Time US Diagnosis for Perithyroidal Invasion of Thyroid Malignancy

갑상선암의 갑상선 주위 침범에 대한 실시간 초음파 진단

  • Heo, Young-Jin (Department of Radiology, Busan Paik Hospital, Inje University School of Medicine) ;
  • Kim, Dong-Wook (Department of Radiology, Busan Paik Hospital, Inje University School of Medicine)
  • 허영진 (인제대학교 의과대학 부산백병원 영상의학과학교실) ;
  • 김동욱 (인제대학교 의과대학 부산백병원 영상의학과학교실)
  • Published : 2011.07.01
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Abstract

Purpose: To assess the diagnostic accuracy of real-time ultrasound (US) for perithyroidal invasion of thyroid malignancy. Materials and Methods: From January 2009 to December 2009, real-time US was performed on malignant thyroid nodules (largest diameter ${\geq}$ 10 mm) located in the isthmus or attached to the adjacent tracheal wall, by a single radiologist who prospectively determined the presence or absence of perithyroidal invasion. Results: Of the 60 malignant thyroid nodules examined, intraglandular location (n = 0), capsular attachment with clear perithyroidal fat (n = 15), perithyroidal fat infiltration without tracheal invasion (n = 43), and tracheal invasion (n = 2) were prospectively determined. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of real-time US diagnosis for perithyroidal invasion were 80%, 90%, 94.1%, 69.2% and 83.3%, respectively when the pathological result was used as reference standard. Real-time US accuracies for intraglandular location, capsular attachment with clear perithyroidal fat, perithyroidal fat infiltration without tracheal invasion, and tracheal invasion were 76.6%, 53.3%, 51.7%, and 85.0%, respectively. Conclusion: The results of the real-time US diagnoses indicate that this method may be useful for diagnosing perithyroidal invasion of thyroid malignancies. Hence, further research is needed to prove the use of diagnosing perithyroidal invasion of thyroid malignancies.

목적: 갑상선암의 갑상선 주위 침범에 대한 실시간 초음파 진단의 정확도를 알아보고자 하였다. 대상과 방법: 2009년 1월부터 2009년 12월까지 본원에서 수술 전 갑상선 초음파 검사에서 갑상선암의 장경이 10 mm 이상인 증례에 대하여 한 명의 영상의학과 전문의가 실시간 초음파 검사를 시행하였으며, 갑상선암의 갑상선 주위와 기관 침범 여부를 전향적으로 진단하였다. 초음파 진단과 수술로 확진된 병리결과를 비교 분석하여, 실시간 초음파 검사의 진단 정확도를 평가하였다. 결과: 총 60명의 환자에서 장경 10 mm 이상인 악성 갑상선 결절 60개에서 갑상선 내 위치(n = 0), 갑상선막 침범(n = 15), 갑상선 주위 침범(n = 43) 및 기관 침범(n = 2)을 보였다. 실시간 초음파 진단을 병리 소견과 비교하였을 때 실시간 초음파 진단은 진양성 32, 위양성 2, 진음성 18, 위음성 8이었으며, 민감도 80%, 특이도 90%, 양성예측도 94.1%, 음성예측도 69.2% 및 정확도 83.3%였다. 갑상선 내 위치, 갑상선막 침범, 갑상선 주위 침범, 기관 침범에 대한 실시간 초음파 진단의 정확도는 각각 76.6%, 53.3%, 51.7% 및 85.0%였다. 결론: 갑상선암의 갑상선 주위 침범에 대한 실시간 초음파 진단의 정확도는 비교적 높았으나 기관 침범에 대한 초음파 진단의 민감도와 양성예측도는 낮았다.

Keywords

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