CT imaging features and its correlation with histopathology of thyroid nodules in children

Objective To investigate the CT features of benign and malignant thyroid nodules in children and their correlation with histopathology of thyroid nodules. Methods The clinical data of 28 children with thyroid nodules confirmed by pathological diagnosis in Shanghai Children′s Hospital from June 2014 to October 2017 were retrospectively analyzed.The CT imaging features and pathological results were compared and analyzed. Results The thyroid nodules of benign, malignant and uncertain malignant potential nodules in this group respectively were 35 nodules (11 cases), 15 nodules (10 cases) and 8 nodules (7 cases) respectively, with a total of 58 nodules.Benign and uncertain malignant potential nodules were all(100.0%) enveloped, 4 nodules(11.4%, 4/35 nodules) were benign nodules and 1 nodule (12.5%, 1/8 nodules) was uncertain malignant potential nodules and its capsule was incomplete.There were 11 nodules(73.3%, 11/35 nodules) malignant nodules without capsule and 4 nodules(26.7%, 4/15 nodules) were malignant nodules with incomplete capsule.In the benign nodules, 9 nodules(25.7%, 9/35 nodules) of them were cystic, and the others were solid or solid cystic (74.3%, 26/35 nodules). All of the malignant nodules and uncertain malignant potential nodules were solid or solid cystic nodules.Benign nodules and uncertain malignant potential nodules were mostly had clear edges, but the edges of malignant nodules were not clear.There were 2 cases(18.2%, 2/11 cases) of the benign nodules which had calcification, 8 cases(80.0%, 8/10 cases) of the malignant nodules had calcification, and 3 cases (42.9%, 3/7 cases)of the uncertain malignant potential nodules had calcification.There was no lymph node metastasis in the patients with benign and uncertain malignant potential nodules.In the malignant nodules, there were 7 cases with lymph node metastasis, accounting for 70.0%(7/10 cases). It had certain reference value for the differentiation of benign and malignant nodules to know whether the boundary of the mass was clear or not, whether the capsule was intact or not, and whether there was calcification or not.The surrounding lymph node enlargement had certain reference value for the differential diagnosis of benign and malignant nodules.The diagnostic results of CT and the coincidence rate of pathological histological diagnosis after operation, the benign nodules and malignant nodules, and also the uncertain malignant potential were respectively 61.1%(11/18 cases), 90.0%(9/10 cases) and 14.3%(1/7 cases). The thyroid nodules of uncertain malignant potential CT imaging were lack of specificity, and definite diagnosis should be based on pathology. Conclusions There is a certain relationship between CT imaging features and pathology of thyroid nodules, which is of great value for the diagnosis and differential diagnosis of thyroid nodules in children. Key words: Thyroid nodules; CT imaging feature; Pathology; Child