title: Gray-scale and color Doppler ultrasonographic manifestations of papillary thyroid carcinoma: analysis of 51 cases.
abstract: The purpose of this study is to assess the specific ultrasonic characteristics of papillary thyroid carcinoma and to determine the relative frequency of various patterns of papillary carcinoma on gray-scale ultrasonography (US) and color Doppler ultrasonography (CDU).
  
  
  METHODS
  We retrospectively reviewed US features in 51 patients with confirmed papillary thyroid carcinoma. The features were analyzed based on tumor size, echogenicity, echotexture, boundary, margin, shape, and calcification pattern on gray-scale US imaging, and on patterns of vascularity on CDU. We obtained the relative frequency of features and classified these features into three categories: common (> or =50% of lesions), less common (>10% but <50%), and uncommon (< or =10%). Individual differences and combinations of features were also analyzed.
  
  
  RESULTS
  In total, 67 nodules were enrolled in our study. The sizes of 76% of nodular lesions were <20.0 mm. Common US features of papillary carcinoma included: a homogeneous hypoechoic solid picture; a poorly defined boundary; an irregular margin; the absence of halo; the absence of calcifications or microcalcifications; and mixed perinodular and intranodular blood flow patterns. Less common features included: a heterogeneous hypoechoic or very hypoechoic picture; microcalcifications; a well-defined boundary; a regular margin; a halo with uneven thickness or an incomplete halo; and a taller-than-wide shape. Uncommon features included: an isoechoic picture; solid with cystic components; coarse calcifications; mixed coarse calcifications and microcalcifications; "inferno"-type blood flow; and absence of blood flow. On average, each nodule had 4.9 US features considered common, 1.8 US features considered less common, and 0.4 US feature considered uncommon. Features such as predominantly cystic composition, hyperechoic texture, and hypoechoic halo with even thickness were never found in our study. The top two common manifestations of papillary carcinoma were solid architecture and mixed perinodular and intranodular blood flow signals.
  
  
  CONCLUSIONS
  All lesions in our series had a predominantly solid characteristic on gray-scale US.
authors.affiliation: Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan. williamyuan.tw@yahoo.com
authors.forename: Wei-Hsin
authors.initials: WH
authors.lastname: Yuan
authors.forename: Hong-Jen
authors.initials: HJ
authors.lastname: Chiou
authors.forename: Yi-Hong
authors.initials: YH
authors.lastname: Chou
authors.forename: Hui-Chen
authors.initials: HC
authors.lastname: Hsu
authors.forename: Chui-Mei
authors.initials: CM
authors.lastname: Tiu
authors.forename: Chang-Yen
authors.initials: CY
authors.lastname: Cheng
authors.forename: Chen-Hsen
authors.initials: CH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color / Q000379:methods*