ÖZET
Amaç:
Benign ve benign olmayan tiroid nodülleri arasındaki ayrım, klinik pratikte çözülmesi gereken karmaşık bir problemdir. Bu çalışma, ince iğne aspirasyon biyopsisi (İİAB) öncesinde benign ve benign olmayan tiroid nodüllerini ayırt etmede shear-wave elastografinin (SWE) rolünü gözlemlemeyi ve tanımlamayı amaçlamaktadır.
Yöntemler:
Mart 2019-Ocak 2020 tarihleri arasında tiroid nodülü olan 97 hasta prospektif olarak çalışmaya dahil edildi. Otoimmin tiroid hasalığı, tiroid cerrahisi, travması veya enfeksiyonu, tanısal olmayan histopatolojisi (Bethesda 1) olan hastalar çalışma dışı bırakıldı. Radyolojik sınıflandırma için 2017 American College of Radiology (ACR) tiroid görüntüleme raporlama ve veri sistemi (TIRADS) kullanıldı. Hastaların yaşı, tiroid nodül sayısı, nodüllerin SWE değeri ve TI-RADS kategorileri patolojik sınıflarına göre karşılaştırıldı.
Bulgular:
Hastaların ortalama yaşı 49,80±11,42 yıl idi. Olgular patolojik tanılarına göre “Grup 1” (G1) (n=79) ve “Grup 2” (G2) (n=12) olarak iki gruba ayrıldı. Benign ve benign olmayan grupdaki hastaların medyan SWE değerleri sırasıyla 9,47 (7,48) ve 47,38 (51,46) kPa idi. G2’nin medyan SWE değerleri G1’den yüksekti ve bu fark istatistiksel olarak anlamlı olarak bulundu (p=0,001). G1’deki hastaların yaklaşık %50’si TI-RADS kategori 3 iken, T1-RADS 5 oranı G2’deki hastaların %40’ının üzerindeydi.
Sonuç:
2017 ACR’ye dayalı TI-RADS sınıflamasına ek olarak, tiroid nodüllerinin shear-wave elastografi ölçümleri İİAB öncesi benign ve benign olmayan tiroid nodüllerinin ayrımında kullanılabilir. Bu nedenle, tanının özgüllüğünü, duyarlılığını ve doğruluğunu artırmak için her iki yöntem birlikte uygulanabilir.
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