Diagnostic value of ultrasonography to distinguish between benign and malignant lesions in the management of thyroid nodules.
OBJECTIVE
We analyzed the sonographic characteristics of thyroid nodules and assessed the diagnostic value of ultrasonography in order to distinguish between benign and malignant lesions in terms of the management of thyroid nodules.


METHODS
We retrospectively analyzed the sonographic features of thyroid nodules in 580 patients who had been examined with fine-needle aspiration cytology or who underwent surgery for a thyroid nodule. The sonographic features that suggested malignancy include microcalcifications, an irregular or microlobulated margin, marked hypoechogenicity, and a shape that was taller than it was wide. The presence of one or more of these features indicated classification as category 3 (malignant). The absence of all of these features indicated classification as category 2 (benign). Presence of an anechogenic cystic nodule was classified as category 1 (benign).


RESULTS
Of 124 lesions classified as category 3, 60 of the lesions were malignant. Of 418 lesions classified as category 1 or 2, 409 were benign. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy based on the sonographic classification method were 87.0%, 86.5%, 48.4%, 97.8%, and 86.5%, respectively.


CONCLUSIONS
Our results identified this sonographic classification as a useful tool in the differentiation of malignant nodules from benign nodules. In view of the high negative predictive value of sonographic classification, a more aggressive approach is recommended only for category 3 nodules.
Tae
Hyun Jung
HJ
Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea.
Lim
Dong Jun
DJ
Baek
Ki Hyun
KH
Park
Woo Chan
WC
Lee
Youn Soo
YS
Choi
Jung Eun
JE
Lee
Jong Min
JM
Kang
Moo Il
MI
Cha
Bong Yun
BY
Son
Ho Young
HY
Lee
Kwang Woo
KW
Kang
Sung Koo
SK
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging*; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000628:therapy; D014463:Ultrasonography