|
Relationship of Shape of Macrocalcification and Thyroid
Cancer: Correlation with US and Pathologic Findings |
|
Sun Young Lee, MD Han Bee Lee, MD, Woo Ho Cho, MD, Jae Hyung Kim, MD,
Myeong Ja Jeong, MD, Soung Hee Kim, MD, Ji-Young Kim, MD,
Soo Hyun Kim, MD, Mi-Jin Kang, MD, Jihae Lee, MD |
|
Department of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul,
Korea |
|
Purpose: The purpose of this study was to categorize macrocalcifications into several
subtypes by the US findings and to determine which type of macrocalcification in
a thyroid nodule is associated with thyroid malignancy.
Materials and Methods: We retrospectively analyzed the macrocalcification patterns
of thyroid nodules in 396 patients that underwent ultrasonography (US)-guided
thyroid FNA or surgery in our institution between August 2009 and August 2011. Two
radiologists evaluated US findings and categorized macrocalcifications into 5 subtyes :
(A) solitary macrocalcification no association with thyroid nodule; (B) nodular macrocalcification(
s) within indeterminate thyroid nodule; (C) dense macrocalcification without
ability to interpret internal content by its posterior acoustic shadowing; (D) irregular-
shaped macrocalcification(s); (E) macrocalcification with other suspicious malignant
US finding(s). A chi-squared test and a Fisher exact test were used for comparison
of categoric variables. The diagnostic sensitivity, specificity, positive and negative
predictive values (PPV and NPV) were obtained.
Results: Among total of 417 nodules, 114 (27.3%) were suspicious malignancy or
malignancy on histopathological result. Macrocalcification with other malignant US
feature had the highest incidence of malignancy (77.5%), followed by irregular-shaped
macrocalcification(s) (43.9%), and dense macrocalcification without ability to interpret
internal content by its posterior acoustic shadowing (38.5%), solitary macrocalcification
no association with thyroid nodule (8.3%) respectively, and nodular macrocalcification(
s) with indeterminate thyroid nodule had the lowest incidence (7.5%). A nodule
with macrocalcification with other malignant US finding(s) has the highest odds
ratio (42.52), followed by a nodule with irregular-shaped macrocalcification(s) (9.65)
and dense macrocalcification (7.72). Leaving macrocalcification with compositive
malignant findings aside, irregular-shaped macrocalcification is more likely to be associated
with increased risk for malignancy compared with other patterns of macrocalcification.
Conclusions: Irregular-shaped macrocalcification is a fine indicator for differentiation
between benign and malignant thyroid nodules on ultrasonography. |
|
Keyword : Thyroid; Macrocalcification; Thyroid carcinoma; Ultrasonography |
|
pdf파일 : 225-231이선영.pdf
|
|