| Flow pattern and vascular resistive index as predictors of malignancy risk in thyroid follicular neoplasms. | |
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MedLine Citation:
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PMID: 15972703 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The purpose of this study was to evaluate whether flow pattern and resistive index (RI) are useful parameters for distinguishing benign from malignant thyroid follicular neoplasms (FNs). METHODS: Eighty-six thyroid nodules that underwent sonographically guided fine-needle aspiration and were diagnosed as cases of FN were evaluated by power and duplex Doppler sonography. Pathologic correlation was available for all nodules. The flow pattern seen via power Doppler examination was ranked for each nodule on a scale of 0 to 4, in increasing flow order. For each nodule, the RI value was considered the average of 1 to 3 values obtained with different flow signals. RESULTS: Ten nodules (11.63%) were malignant (3 follicular carcinomas, 5 follicular variants of papillary carcinoma, and 2 papillary carcinomas). Fourteen nodules (16.27%) were adenomas, and 62 (72%) were non-neoplastic nodules. The average RI in non-neoplastic nodules was 0.588 (P < .001, chi(2) test): 0.662 in adenomas and 0.763 in malignant nodules. None of the nodules had flow pattern type 0. Flow patterns 1 and 2 (peripheral flow only or predominantly) were present in 58 non-neoplastic nodules (93.5%), 10 adenomas (71.4%), and 2 malignant nodules (20%). Flow pattern type 3 (predominantly central flow) was present in 7 malignant nodules (70%), 4 adenomas (28.6%), and 4 non-neoplastic nodules (6.5%). Only 1 nodule, a papillary carcinoma, had flow pattern type 4 (internal flow only). CONCLUSIONS: In FNs, there were significant positive associations between predominantly central flow and malignancy and between predominantly peripheral flow and benign disease (P < .0001, Fisher exact test). However, power Doppler characteristics could not be used to rule out malignancy because 20% of malignant nodules had predominantly peripheral flow. For predicting malignancy, an RI cutoff of 0.75 had good accuracy, specificity, and negative predictive value but had low sensitivity and positive predictive value (respectively, 91%, 97%, 92%, 40%, and 67%). Resistive index values in non-neoplastic nodules were lower than in adenomas and malignant nodules (P < .001, chi(2) test). |
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Authors:
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Harley De Nicola; Jacob Szejnfeld; Angela Flávia Logullo; Angela Maria Borri Wolosker; Luis Ronan Marquez F Souza; Valcir Chiferi |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine Volume: 24 ISSN: 0278-4297 ISO Abbreviation: J Ultrasound Med Publication Date: 2005 Jul |
Date Detail:
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Created Date: 2005-06-23 Completed Date: 2006-01-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8211547 Medline TA: J Ultrasound Med Country: United States |
Other Details:
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Languages: eng Pagination: 897-904 Citation Subset: IM |
Affiliation:
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Diagnostic Imaging Department, Federal University of São Paulo-Escola Paulista de Medicina, São Paulo, Brazil. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenoma
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blood supply*,
diagnosis* Carcinoma / blood supply*, diagnosis* Humans Predictive Value of Tests Regional Blood Flow Reproducibility of Results Risk Factors Sensitivity and Specificity Statistics, Nonparametric Thyroid Neoplasms / blood supply*, diagnosis* Thyroid Nodule / blood supply, ultrasonography Ultrasonography, Doppler, Color / methods Ultrasonography, Doppler, Duplex / methods Vascular Resistance* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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