Thyroid Nodules with Macrocalcification: Sonographic Findings Predictive of Malignancy
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초록
Purpose: To analyze which sonographic features of thyroid nodules with macrocalcificationswere predictable of thyroid malignancy. Materials and Methods: We reviewed sonographic findings of 854 macrocalcified thyroid nodules in patients who underwent fine needle aspiration biopsy between December 2009 and January 2011. There were 171 non-diagnostic aspirations, 34 nodules with category 3, 4, 5 based on Bethesda system, which were not confirmed by surgery, and these nodules were excluded from the analysis. Sonographic characteristics of the macrocalcificationsincluding its thickness, interruption, and existence of soft tissue rim outside the macrocalcification were analyzed. Other sonographic characteristics of nodules such as shape, margin, composition, echo pattern, vascularity, and underlying parenchymalechogenicity were also evaluated. The correlation of sonographic featureswith cytopathologic results and the diagnostic performance of sonographic features for the prediction of malignancy were analyzed. Results: Among 649 nodules,179 (27.6%) nodules were malignant and 470 (72.4%) nodules were benign. Among the features of the macrocalcification, interruption, irregular thickness, or the presence of soft tissue outside calcification rim were associated with malignancy(p<0.001). A high sensitivity and negative predictive values for the prediction of malignancy was found in sonographic characteristics of irregular thickness (92.2% and 91.0%, respectively) and the presence of soft tissue (88.5% and 88.8%, respectively). Conclusion: Sonographic characteristics of macrocalcification such as interruption,irregular thickness and the presence of soft tissue rim were associated with malignancy in thyroid nodules with macrocalcifications.
Abstract
Purpose: To analyze which sonographic features of thyroid nodules with macrocalcificationswere predictable of thyroid malignancy. Materials and Methods: We reviewed sonographic findings of 854 macrocalcified thyroid nodules in patients who underwent fine needle aspiration biopsy between December 2009 and January 2011. There were 171 non-diagnostic aspirations, 34 nodules with category 3, 4, 5 based on Bethesda system, which were not confirmed by surgery, and these nodules were excluded from the analysis. Sonographic characteristics of the macrocalcificationsincluding its thickness, interruption, and existence of soft tissue rim outside the macrocalcification were analyzed. Other sonographic characteristics of nodules such as shape, margin, composition, echo pattern, vascularity, and underlying parenchymalechogenicity were also evaluated. The correlation of sonographic featureswith cytopathologic results and the diagnostic performance of sonographic features for the prediction of malignancy were analyzed. Results: Among 649 nodules,179 (27.6%) nodules were malignant and 470 (72.4%) nodules were benign. Among the features of the macrocalcification, interruption, irregular thickness, or the presence of soft tissue outside calcification rim were associated with malignancy(p<0.001). A high sensitivity and negative predictive values for the prediction of malignancy was found in sonographic characteristics of irregular thickness (92.2% and 91.0%, respectively) and the presence of soft tissue (88.5% and 88.8%, respectively). Conclusion: Sonographic characteristics of macrocalcification such as interruption,irregular thickness and the presence of soft tissue rim were associated with malignancy in thyroid nodules with macrocalcifications.
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