Role of Ultrasound in Decision-making of Surgery for Thyroid Nodules: A Retrospective Analysis of Cases of Peking Union Medical College Hospital in Past 11 Years

  Objective  To investigate the role of ultrasound in the decision-making of surgery for thyroid nodules.

  Methods  The cases receiving surgical excision of thyroid nodules in Peking Union Medical College Hospital during the period of January 2004 to December 2014 were collected. We randomly sampled 10%-15% cases from the collections in 2004, 2006, 2008, 2010, 2012 and 2014, and reviewed the outpatient and inpatient records of these sampled cases, extracting information about whether preoperative ultrasonography examination was ordered, whether the ultrasound report provided specific diagnostic suggestion, and whether that diagnosis was correct judging from pathological results. The rates of preoperative ultrasound, ultrasound diagnostic suggestion, specific diagnostic suggestion, and correct ultrasound diagnosis were calculated.

  Results  The number of thyroid nodule surgery increased year by year from 2004 to 2014, with the proportion of malignant nodules rising from 15.65% in 2004 to 69.91% in 2014.The rate of preoperative ultrasound ranged from 80.65% to 96.65%. The rate of ultrasound diagnostic suggestion demonstrated a constantly ascending trend, ranging from 46.94% to 92.36%. The rate of specific diagnostic suggestion was in the range of 78.26%-93.61%, while the rate of correct ultrasound diagnosis grew year by year, from 36.73% to 81.40%.

  Conclusions  The numbers of patients with thyroid nodules and thyroid cancer have been soaring in the past 11 years. With the improvement in its diagnostic capacity, ultrasonography is playing an increasingly important role in the decision-making of surgery for thyroid nodules.