| Role of conventional ultrasonography and color flow-doppler sonography in predicting malignancy in 'cold' thyroid nodules. | |
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MedLine Citation:
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PMID: 9461314 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The aim of the present study was to establish the usefulness of conventional thyroid ultrasonography (US) and color flow-doppler (CFD) sonography in the assessment of 'cold' thyroid nodules. One hundred and four consecutive patients with thyroid nodules who were to undergo surgery were examined by US and CFD before thyroidectomy. Conventional US evaluated the presence of a halo sign, hypoechogenicity and microcalcifications. The vascular pattern on CFD was classified as follows: Type I, absence of blood flow; Type II, perinodular blood flow; Type III, marked intranodular blood flow. On histology, 30 nodules were diagnosed as malignant (carcinoma, CA) and 74 as benign nodules (BN). On US, the echographic pattern most predictive for malignancy was absent halo sign, which was found in 20/30 CA and in 17/72 BN (P = 0.0001; specificity 77.0%; sensitivity 66.6%). The most specific combination on US, absent halo sign/microcalcifications, was found in 8/30 CA and in 5/74 BN (P < 0.005; specificity 93.2%, sensitivity 26.6%). The Type III pattern on CFD was found in 20/30 CA and 38/74 BN (not statistically significant). The combination of absent halo sign on US with Type III pattern on CFD was found in 15/30 CA and in 8/74 BN (P < 0.0001; specificity 89.0%, sensitivity 50.0%). The combination of absent halo sign/microcalcifications on US with Type III pattern on CFD was the most specific combination of the two techniques, being found in 5/30 CA and in only 2/74 BN (P < 0.01; specificity 97.2%, sensitivity 16.6%). In conclusion, findings on US and CFD become highly predictive for malignancy only when multiple signs are simultaneously present in a thyroid nodule. Thus the predictive value of these techniques increases at the expense of their sensitivity. Only in a small proportion of patients with thyroid carcinoma is US and CFD information highly predictive of malignancy. |
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Authors:
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T Rago; P Vitti; L Chiovato; S Mazzeo; A De Liperi; P Miccoli; P Viacava; F Bogazzi; E Martino; A Pinchera |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: European journal of endocrinology / European Federation of Endocrine Societies Volume: 138 ISSN: 0804-4643 ISO Abbreviation: Eur. J. Endocrinol. Publication Date: 1998 Jan |
Date Detail:
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Created Date: 1998-03-04 Completed Date: 1998-03-04 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9423848 Medline TA: Eur J Endocrinol Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 41-6 Citation Subset: IM |
Affiliation:
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Istituto di Endocrinologia, University of Pisa, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Child Female Humans Male Middle Aged Predictive Value of Tests Thyroid Neoplasms / etiology* Thyroid Nodule / complications*, radionuclide imaging, ultrasonography* Ultrasonography, Doppler, Color* |
| Comments/Corrections | |
Comment In:
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Eur J Endocrinol. 1998 Jan;138(1):30-1
[PMID:
9461311
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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