Sonographic diagnosis of thyroid nodules: correlation with the results of sonographically guided fine-needle aspiration biopsy.
OBJECTIVE
To assess the reliability of sonography in differentiating benign from malignant thyroid nodules and selecting lesions for fine-needle aspiration (FNA).


METHODS
During a 2-year period, the following 7 sonographic parameters were assessed in 129 patients with thyroid nodules: size, number, echogenicity, echotexure, margin regularity, presence of calcifications, and presence of a hypoechoic rim. Sonographically guided FNA was performed on thyroid nodules 5 mm in diameter. Out of 184 FNAs, we obtained 168 specimens adequate for cytologic analysis and 16 (9%) nondiagnostic specimens.


RESULTS
FNA diagnoses included 150 (89%) benign and 18 (11%) malignant nodules. Among 53 solitary nodules, 11 were carcinomas and 42 were benign (p < 0.01). The mean size of the carcinomas was 28 +/- 12 mm versus 18 +/- 10 mm for benign nodules (p < 0.01). The following sonographic features were significantly associated with malignancy: hypoechogenicity, irregular margins, calcifications, and absence of a hypoechoic rim. Differences in echotexure between malignant and benign nodules were not statistically significant.


CONCLUSIONS
Sonographically guided FNA should be performed on thyroid nodules 5 mm in diameter with sonographic characteristics that suggest malignancy.
Kovacevic
Dragica Obad
DO
Department of Diagnostic and Interventional Radiology, University Hospital Merkur, Zajceva 19, 10000 Zagreb, Croatiá.
Kovacevic
Obad
O
Skurla
Mirna Smetana
MS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000473:pathology; D018084:Ultrasonography, Interventional