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2021, Number 1

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Rev Cub Med Mil 2021; 50 (1)

Diagnostic value of ultrasound in nodular thyroid lesions

González TR, Fernández CO, Castillo LL

Language: Spanish
References: 20
Page:
PDF size: 370.29 Kb.


ABSTRACT

Introduction: The risk of malignancy of a thyroid nodule can be stratified from ultrasound signs. Various systems have been used for this purpose, although without consensus on which to use.
Objective: To evaluate the diagnostic utility, for nodular disease, of the ultrasound signs, as well as of four systems of stratification of the risk of malignancy.
Methods: A prospective study was conducted that included 151 thyroid nodules. Thyroid ultrasound identified composition, echogenicity, shape, margins and echogenic foci. The risk of malignancy of each nodule was estimated according to four stratification systems. They were diagnosed benign or malignant according to cytological study, surgery, or a minimum follow-up of two years. The relationship between the clinical characteristics was identified, as well as the risk stratification systems and the chi-square diagnosis. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic precision of each ultrasound sign were calculated.
Results: A relationship was found between family history and physical examination with the diagnosis of malignancy. The best diagnostic precision corresponded to cystic composition (90.0%), anechoic (90.1%), irregular margins (95.4%) and peripheral calcifications (92.7%). All the ultrasound risk stratification systems for malignancy were able to adequately discriminate between malignant and benign lesions (p <0.05).
Conclusions: The highest risk of malignancy was presented by solid, hypoechoic nodules, with irregular margins and with microcalcifications. All four malignancy risk stratification systems are adequate, although the American College of Radiology is more accurate.


REFERENCES

  1. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016[acceso: 20/06/2020]; 26(1):1-133. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4739132/

  2. Dean DS, Gharib H. Epidemiology of thyroid nodules. Best Practice & Research Clinical Endocrinology & Metabolism. 2008[acceso: 20/06/2020]; 22(6):901-11. Disponible en: https://www.clinicalkey.es/#!/content/journal/1-s2.0-S1521690X08001139

  3. Reiners C, Wegscheider K, Schicha H, Theissen P, Vaupel R, Wrbitzky R, et al. Prevalence of Thyroid Disorders in the Working Population of Germany: Ultrasonography Screening in 96,278 Unselected Employees. Thyroid. 2004[acceso: 20/06/2020]; 14(11):926-32. Disponible en: https://www.liebertpub.com/doi/abs/10.1089/thy.2004.14.926

  4. Guth S, Theune U, Aberle J, Galach A, Bamberger CM. Very high prevalence of thyroid nodules detected by high frequency (13MHz) ultrasound examination. European Journal of Clinical Investigation. 2009[acceso: 20/06/2020]; 39(8):699-706. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2362.2009.02162.x

  5. Bustillo Madrigal E, Bustillo Solano E, Denis Cancio H. Prevalencia y caracterización de la enfermedad tiroidea nodular y del bocio difuso en un área urbana. Revista Cubana de Endocrinología. 2014[acceso: 20/06/2020]; 25:87-103. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561-29532014000200006&nrm=iso

  6. Russ G, Bonnema SJ, Erdogan MF, Durante C, Ngu R, Leenhardt L. European Thyroid Association Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules in Adults: The EU-TIRADS. European Thyroid Journal. 2017[acceso: 20/06/2020]; 6(5):225-37. Disponible en: https://www.karger.com/DOI/10.1159/000478927

  7. Shin JH, Baek JH, Chung J, Ha EJ, Kim J-H, Lee YH, et al. Ultrasonography Diagnosis and Imaging-Based Management of Thyroid Nodules: Revised Korean Society of Thyroid Radiology Consensus Statement and Recommendations. Korean journal of radiology. 2016[acceso: 20/06/2020]; 17(3):370-95. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4842857/

  8. Tessler FN, Middleton WD, Grant EG, Hoang JK, Berland LL, Teefey SA, et al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee. Journal of the American College of Radiology. 2017[acceso: 20/06/2020]; 14(5):587-95. Disponible en: http://www.sciencedirect.com/science/article/pii/S1546144017301862

  9. Cruz Ferreti E, Cordovés Molina K, Cruz Rivas E, Vargas Herrera R, Méndez Méndez O. Ecografía de los nódulos tiroideos y su correspondencia citológica. Correo Científico Médico de Holguín. 2010[acceso: 20/06/2020]; 14(3): [aprox. 12 p.]. Disponible en: http://www.cocmed.sld.cu/no143/no143ori06.htm

  10. Castañeda Muñoz ÁM, Castro Morillo AM, Rufín Bergado AM, Ríos Serrano M, González Rodríguez D. Aplicación del sistema de Bethesda en la BAAF de tiroides. Revista Médica Electrónica. 2014[acceso: 20/06/2020]; 36:823-34. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1684-18242014000600003&nrm=iso

  11. Infante Amorós A, Rodríguez Obret Z, Ramos Duarte R. Características clínicas, ultrasonográficas y anatomopatológicas de pacientes operados por sospecha de malignidad tiroidea. Revista Cubana de Endocrinología. 2014[acceso: 20/06/2020]; 25:35-45. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561-29532014000200001&nrm=iso

  12. Grant EG, Tessler FN, Hoang JK, Langer JE, Beland MD, Berland LL, et al. Thyroid Ultrasound Reporting Lexicon: White Paper of the ACR Thyroid Imaging, Reporting and Data System (TIRADS) Committee. Journal of the American College of Radiology. 2015[acceso: 20/06/2020]; 12(12, Part A):1272-9. Disponible en: http://www.sciencedirect.com/science/article/pii/S1546144015006845

  13. Cibas ES, Ali SZ. The Bethesda System for Reporting Thyroid Cytopathology. American Journal of Clinical Pathology. 2009[acceso: 20/06/2020]; 132(5):658-65. Disponible en: http://dx.doi.org/10.1309/AJCPPHLWMI3JV4LA

  14. González Fernández R, de Dios Vidal JM, Infante Amorós A, López Soto MV. Resultados del diagnóstico de la patología nodular tiroidea. Rev Cubana Cir. 2004[acceso: 20/06/2020]; 43(1): [aprox. 9 p.]. Disponible en: http://bvs.sld.cu/revistas/cir/vol43_1_04/cir02104.htm

  15. Rojo Álvaro J, Bermejo Fraile B, Menéndez Torre E, Ardanaz E, Guevara M, Anda Apiñániz E. Increased incidence of thyroid cancer in Navarra (Spain). Evolution and clinical characteristics, 1986-2010. Endocrinologia, Diabetes y Nutricion. 2017[acceso: 20/06/2020]; 64(6):303-9. Disponible en: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85020317188&doi=10.1016%2fj.endinu.2017.02.013&partnerID=40&md5=fd71e7276aea4b6d7fd8ebcaa70806a1

  16. Kim YY, Han K, Kim EK, Moon HJ, Yoon JH, Park VY, et al. Validation of the 2015 American Thyroid Association Management Guidelines for Thyroid Nodules With Benign Cytologic Findings in the Era of the Bethesda System. AJR Am J Roentgenol. 2018[acceso: 20/06/2020]; 210(3):629-34. Disponible en: https://www.ajronline.org/doi/full/10.2214/AJR.17.18507

  17. Tang AL, Falciglia M, Yang H, Mark JR, Steward DL. Validation of American Thyroid Association Ultrasound Risk Assessment of Thyroid Nodules Selected for Ultrasound Fine-Needle Aspiration. Thyroid. 2017[acceso: 20/06/2020]; 27(8):1077-82. Disponible en: https://www.liebertpub.com/doi/pdf/10.1089/thy.2016.0555

  18. Middleton WD, Teefey SA, Reading CC, Langer JE, Beland MD, Szabunio MM, et al. Comparison of Performance Characteristics of American College of Radiology TI-RADS, Korean Society of Thyroid Radiology TIRADS, and American Thyroid Association Guidelines. AJR Am J Roentgenol. 2018[acceso: 20/06/2020]; 210(5):1148-54. Disponible en: https://www.ajronline.org/doi/10.2214/AJR.17.18822

  19. Pandya A, Caoili EM, Jawad-Makki F, Wasnik AP, Shankar PR, Bude R, et al. Retrospective Cohort Study of 1947 Thyroid Nodules: A Comparison of the 2017 American College of Radiology TI-RADS and the 2015 American Thyroid Association Classifications. American Journal of Roentgenology. 2020[acceso: 20/06/2020]; 214(4):900-6. Disponible en: https://doi.org/10.2214/AJR.19.21904

  20. Yoon SJ, Na DG, Gwon HY, Paik W, Kim WJ, Song JS, et al. Similarities and Differences Between Thyroid Imaging Reporting and Data Systems. American Journal of Roentgenology. 2019[acceso: 20/06/2020]; 213(2):76-84. Disponible en: https://doi.org/10.2214/AJR.18.20510




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