Vol 67, No 2 (2016)
Original paper
Published online: 2016-01-21

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Differentiation of thyroid nodules in multinodular goiter with the application of technical ultrasound advances — initial results

Bartosz Migda, Rafal Słapa, Jacek Bierca, Jadwiga Slowińska-Srzednicka, Anna Migda, Katarzyna Dobruch-Sobczak, Wiesław Jakubowski
DOI: 10.5603/EP.a2016.0026
Pubmed: 26884295
Endokrynol Pol 2016;67(2):157-165.


Introduction: To evaluate the relative value of technical ultrasound advances in differentiation of thyroid nodules in multinodular goitre.

Material and methods: The study included patients with multinodular goitre, who were referred for thyroidectomy. Ultrasound evaluation of suspicious nodules was performed with: improved B-mode (spatial compound imaging and differential tissue harmonics), dedicated mapping of microcalcifications, mapping of the nodule vessels, and strain elastography evaluated qualitatively and semi quantitatively.

Results: A total of 163 nodules in 124 patients with multinodular goitre were evaluated (147 benign and 16 cancers). Improved B-mode imaging was: 76.76% sensitive and 62.5% specific with AUC 0.740. Differentiating B-mode features were: shape — taller than wide OR 15.8, markedly hypoechoic OR 14.7, absence of cystic areas OR 6.6, absence of halo OR 5.0, and blurred/microlobulated margins OR 3.7. Addition of MicroPure imaging was 80.28% sensitive and 68.75% specific with AUC 0.771. MicroPure alone, power Doppler, and strain elastography were not statistically significant.

Conclusions: Among singular modes of ultrasound imaging, only improved B-mode imaging proved to have a significant role in differentiation of thyroid nodules in multinodular goitre. Additional gain was seen with the addition to B-mode of the mapping of microcalcifications with MicroPure imaging. Power Doppler and strain elastography did not prove to be useful techniques in multinodular goitre. (Endokrynol Pol 2016; 67 (2): 157–165)