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Differentiation of thyroid nodules with macrocalcifications: role of suspicious sonographic findings

 Min Jung Kim  ;  Eun-Kyung Kim  ;  Jin Young Kwak  ;  Cheong Soo Park  ;  Woong Youn Chung  ;  Kee-Hyun Nam  ;  Ji Hyun Youk 
 JOURNAL OF ULTRASOUND IN MEDICINE, Vol.27(8) : 1179-1184, 2008 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Calcinosis/diagnostic imaging* ; Child ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; Sensitivity and Specificity ; Thyroid Nodule/diagnostic imaging* ; Ultrasonography
calcifications ; sonography ; thyroid.
OBJECTIVE: The purpose of this study was to determine which types of macrocalcifications are associated with thyroid carcinoma and to assess the role of other suspicious sonographic findings in thyroid nodules with macrocalcifications. METHODS: Our Institutional Review Board approved this retrospective study, and informed consent was not required. We reviewed sonographic findings of thyroid nodules in 722 patients that underwent thyroid surgery in our institution between March 2006 and August 2006. Sonographic results were grouped into 3 types of macrocalcifications. Each lesion was evaluated on the basis of other suspicious sonographic criteria, including marked hypoechogenicity, irregular or microlobulated margins, and a taller-than-wide shape. Sensitivity and specificity based on sonographic criteria were calculated and compared among the subtypes of macrocalcifications. RESULTS: One hundred seventy-four nodules showed macrocalcifications; 116 were malignant, and 58 were benign. Among the macrocalcification categories, solitary calcifications were more common in benign thyroid lesions, whereas coarse calcifications not otherwise specified were more common in malignant lesions (P < .05). Although the risk of malignancy was 17.2% in cases with no suspicious sonographic findings, the risk of malignancy was up to 82.8% in cases with at least 1 of the sonographic criteria (P < .05). On the basis of the suspicious sonographic criteria, the overall sensitivity was 82.8%. There was no statistically significant difference in sensitivity among the macrocalcification subtypes (P > .05). CONCLUSIONS: Suspicious sonographic features such as marked hypoechogenicity, irregular or microlobulated margins, and a taller-than-wide shape can play important roles in differentiating benign and malignant thyroid nodules with macrocalcifications.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Jin Young(곽진영) ORCID logo https://orcid.org/0000-0002-6212-1495
Kim, Min Jung(김민정) ORCID logo https://orcid.org/0000-0003-4949-1237
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Nam, Kee Hyun(남기현) ORCID logo https://orcid.org/0000-0002-6852-1190
Park, Cheong Soo(박정수)
Youk, Ji Hyun(육지현) ORCID logo https://orcid.org/0000-0002-7787-780X
Chung, Woung Youn(정웅윤)
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