title: Ultrasonographic Differentiation Between Nodular Hyperplasia and Neoplastic Follicular-Patterned Lesions of the Thyroid Gland.
abstract: We evaluate the gray-scale ultrasonographic characteristics that differentiate between nodular hyperplasia (NH) and neoplastic follicular-patterned lesions (NFPLs) of the thyroid gland. Ultrasonographic features of 750 patients with 832 thyroid nodules (NH, n = 361; or NFPLs, follicular adenoma, n = 123; follicular carcinoma, n = 159; and follicular variant papillary carcinoma, n = 189) were analyzed. Except for echogenicity, over two-thirds of the cases of NH and NFPLs share the ultrasonographic characteristics of solid internal content, a well-defined smooth margin and round-to-ovoid shape. Independent predictors for NH were non-solid internal content (sensitivity 27.1%, specificity 90.2%), isoechogenicity (sensitivity 69.5%, specificity 63.5%) and an ill-defined margin (sensitivity 18.8%, specificity 94.5%). Independent predictors for NFPLs were hypoechogenicity (sensitivity 60.5%, specificity 70.4%), marked hypoechogenicity (sensitivity 2.8%, specificity 99.4%) and taller-than-wide shape (sensitivity 6.6%, specificity 98.1%). Although NH and NFPLs commonly share ultrasonographic characteristics, non-solid internal content and ill-defined margin are specific to NH and marked hypoechogenicity and taller-than-wide shape are specific to NFPLs.
authors.affiliation: Department of Radiology, Seoul National University Hospital, Jongno-gu, Seoul, Korea.
authors.forename: Yong Sub
authors.initials: YS
authors.lastname: Song
authors.affiliation: Department of Radiology, Seoul National University Hospital, Jongno-gu, Seoul, Korea. Electronic address: jihnkim@gmail.com.
authors.forename: Ji-Hoon
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Radiology, Thyroid Clinic, Human Medical Imaging & Intervention Center, Seoul, Korea.
authors.forename: Dong Gyu
authors.initials: DG
authors.lastname: Na
authors.affiliation: Department of Pathology, Seoul National University College of Medicine, Seoul, Korea; Department of Preventive Medicine, Graduate School of Public Health, Seoul National University Hospital, Seoul, Korea.
authors.forename: Hye Sook
authors.initials: HS
authors.lastname: Min
authors.affiliation: Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jae-Kyung
authors.initials: JK
authors.lastname: Won
authors.affiliation: Department of Radiology, Seoul National University Hospital, Jongno-gu, Seoul, Korea.
authors.forename: Tae Jin
authors.initials: TJ
authors.lastname: Yun
authors.affiliation: Department of Radiology, Seoul National University Hospital, Jongno-gu, Seoul, Korea.
authors.forename: Seung Hong
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Department of Radiology, Seoul National University Hospital, Jongno-gu, Seoul, Korea.
authors.forename: Chul-Ho
authors.initials: CH
authors.lastname: Sohn
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000000981:diagnostic imaging*; D000236:Adenoma / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013961:Thyroid Gland / Q000000981:diagnostic imaging* / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography / Q000379:methods*
keywords: Follicular adenoma; Follicular carcinoma; Follicular variant papillary carcinoma; Follicular-patterned lesion; Nodular Hyperplasia; Thyroid; Ultrasonography