• Yonsei medical journal · Mar 2014

    Thyroid nodules with macrocalcification: sonographic findings predictive of malignancy.

    • Yun Joo Park, Jeong-Ah Kim, Eun Ju Son, Ji Hyun Youk, Eun-Kyung Kim, Jin Young Kwak, and Cheong Soo Park.
    • Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul 135-720, Korea. chrismd@hanmail.net.
    • Yonsei Med. J. 2014 Mar 1; 55 (2): 339-44.

    PurposeTo analyze which sonographic features of thyroid nodules with macrocalcifications were predictable of thyroid malignancy.Materials And MethodsWe 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 macrocalcifications including 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 parenchymal echogenicity were also evaluated. The correlation of sonographic features with cytopathologic results and the diagnostic performance of sonographic features for the prediction of malignancy were analyzed.ResultsAmong 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).ConclusionSonographic 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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