Thyroid nodules: Re‐evaluation with ultrasound

Abstract

The purpose of this study was to clarify ultrasound (US) evaluation of microcalcifications and determine whether the calcifications seen in US scans can reliably predict malignant thyroid tumors. Diagnostic accuracy of microcalcification and other various signs seen in US scans for predicting malignancy was evaluated prospectively in 259 pathologically verified thyroid nodules. Sonographic and pathologic correlation of calcifications was performed on 69 of 99 surgically removed nodules. Pathologic studies revealed that hyperechoic areas with acoustic shadowing represented mostly amorphous dense calcifications and sometimes microcalcifications, but small particles without acoustic shadowing mainly reflected microcalcifications and sometimes large amount of fibrous bands and condensed colloids. Of the various sonographic signs, microcalcification showed the highest accuracy (76%), specificity (93%), and positive predictive value (70%) for malignancy as a single sonographic sign, but its sensitivity (36%) was poor. Although sonographic microcalcification showed relatively high specificity, the accuracy of this finding for malignancy was insufficient.

High resolution ultra sound and color Doppler in evaluation of thyroid nodule with fine needle aspiration cytology correlation

“…Micro-calcification showed highest accuracy (76%), specifically (93%), and positive predictive value (70%) for malignancy as single Sonographic sign, but sensitivity (93%) was poor. 9 On color Doppler sonography, preference central hypervascularity was the most common finding in malignant nodules. Among benign nodules, preference perinodular hyper-vascularity was the most common finding.…”

Uso da ultra-sonografia no diagnóstico e seguimento do carcinoma bem diferenciado da tireóide

“…demonstraram que a presença de microcalcificações no interior dos nódulos era a única característica ultra-sonográfica que poderia predizer malignidade (12). Este sinal teve acurácia de 76%, especificidade de 93% e valor preditivo positivo de 70%, mas com uma sensibilidade de apenas 36%.…”

“…Das várias combinações entre microcalcificações e um dos outros achados ultra-sonográficos, a combinação entre microcalcificações e nódulo de textura sólida mostrou a acurá-cia mais alta, de 77%, especificidade de 96% e valor preditivo positivo de 75%, porém a sua sensibilidade foi de apenas 30%. Esses resultados sugerem que, em casos de discrepância entre o diagnóstico ultra-sonográfico e o citológico, todos os outros dados clínicos devem ser considerados e uma nova biópsia para confirmação pode ser também considerada (12).…”

Microcalcificaciones y focos ecogénicos puntiformes, ¿qué tan bien sabemos lo que estamos viendo?

“…En ecografía, las microcalcificaciones en nódulos tiroideos y su relevancia para el diagnóstico ha sido ampliamente estudiada, existiendo una asociación fuerte entre su presencia y el riesgo de malignidad, en especial, en relación al cáncer papilar de tiroides (CPT) 1,2 . Desde un punto de vista anatomopatológico, se considera que representan la presencia de cuerpos de psammoma (CPs) (Figura 1) 3 .…”