The Diagnostic Role of Computed Tomography for ACR TI-RADS 4-5 Thyroid Nodules With Coarse Calcifications.

2020 
Objectives: Coarse calcifications are prone to cause echo attenuation during ultrasonography (US) and hence affect the classification of benign and malignant nodules. This study aimed to investigate the diagnostic role of computed tomography (CT) for differentiating the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) 4-5 nodules with coarse calcifications. Methods: CT data of 216 ACR TI-RADS 4-5 nodules with coarse calcifications confirmed by surgery and pathology in 207 patients were analyzed retrospectively. Halo sign, artifacts, and CT values (i.e., Hounsfield unit) of the nodules were determined by two radiologists. Univariate analysis and binary logistic regression were used to determine the relationship of halo sign, artifact, and CT value with benign nodules. A predictive model for benign nodules with coarse calcifications was then constructed. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of halo sign, artifact, CT value, and logistic regression model. Results: Of the 216 ACR TI-RADS 4-5 nodules with coarse calcifications, 170 were benign and 46 were malignant. There were 92 benign and 7 malignant nodules with halo sign (χ2 = 22.067, P 627.5 Hu were helpful for identifying ACR TI-RADS 4-5 thyroid benign nodules with coarse calcifications. The diagnostic performance of the logistic regression model was higher than that of any single indicator. Accurate identification of these indicators could identify benign nodules and reduce unnecessary surgical trauma.
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