Thyroid follicular neoplasms: Can sonography distinguish between adenomas and carcinomas?

Authors

  • Hyung Suk Seo MD,

    1. Department of Radiology, Korea University Ansan Hospital, 516 Gojan1-dong, Danwon-gu, Ansan-si, Kyunggi-do, 425-707, Korea
    2. Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea
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  • Dong Hoon Lee MD,

    1. Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea
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  • Sung Hye Park MD,

    1. Department of Pathology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea
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  • Hye Sook Min MD,

    1. Department of Pathology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea
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  • Dong Gyu Na MD

    Corresponding author
    1. Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea
    2. Human Medical Imaging & Intervention Center, 12-25, Jamwon-dong, Seocho-gu, Seoul, 137-902, Korea
    • Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea
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Abstract

Purpose

The purpose of this study was to determine whether sonography (US) can usefully differentiate thyroid follicular adenoma (FA) and follicular carcinoma (FC).

Methods

This retrospective study included 60 pathologically proven FAs and 66 FCs in 123 consecutive patients (17 males and 106 females) with a mean age of 47 ± 13 years, (17–73 years) who underwent thyroid surgery. We analyzed US features of each nodule, including maximum diameter, echogenicity, composition, presence of calcification, margins, and presence of halo. The frequencies of each US feature were compared by using the χ2 test or Fisher's exact test between FAs and FCs. The relative risk of malignancy was evaluated by logistic regression analysis.

Results

Isohypoechoic echogenicity, predominantly solid or mixed echotexture, and presence of microcalcifications or rim calcifications were associated with FC (p < 0.05). Logistic regression analysis demonstrated that predominantly solid or mixed echotexture and microcalcifications or rim calcifications were associated with significant increases in relative risk for FC (odds ratio 8.1 and odds ratio 13.5, respectively, p < 0.01).

Conclusions

The US features of isohypoechoic echogenicity, predominantly solid or mixed echotexture, and microcalcifications or rim calcifications are more common in FC than in FA. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009

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