Differentiation of thyroid nodules with macrocalcifications: Role of suspicious sonographic findings

Min Jung Kim, Eun Kyung Kim, Jin Young Kwak, Cheong Soo Park, Woong Youn Chung, Kee Hyun Nam, Ji Hyun Youk

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Objective. The purpose of this study was to determine which types of macrocalcifications are associated with thyroid carcinoma and to assess the role of other suspicious sonographic findings in thyroid nodules with macrocalcifications. Methods. Our Institutional Review Board approved this retrospective study, and informed consent was not required. We reviewed sonographic findings of thyroid nodules in 722 patients that underwent thyroid surgery in our institution between March 2006 and August 2006. Sonographic results were grouped into 3 types of macrocalcifications. Each lesion was evaluated on the basis of other suspicious sonographic criteria, including marked hypoechogenicity, irregular or microlobulated margins, and a taller-than-wide shape. Sensitivity and specificity based on sonographic criteria were calculated and compared among the subtypes of macrocalcifications. Results. One hundred seventy-four nodules showed macrocalcifications; 116 were malignant, and 58 were benign. Among the macrocalcification categories, solitary calcifications were more common in benign thyroid lesions, whereas coarse calcifications not otherwise specified were more common in malignant lesions (P < .05). Although the risk of malignancy was 17.2% in cases with no suspicious sonographic findings, the risk of malignancy was up to 82.8% in cases with at least 1 of the sonographic criteria (P < .05). On the basis of the suspicious sonographic criteria, the overall sensitivity was 82.8%. There was no statistically significant difference in sensitivity among the macrocalcification subtypes (P > .05). Conclusions. Suspicious sonographic features such as marked hypoechogenicity, irregular or microlobulated margins, and a taller-than-wide shape can play important roles in differentiating benign and malignant thyroid nodules with macrocalcifications.

Original languageEnglish
Pages (from-to)1179-1184
Number of pages6
JournalJournal of Ultrasound in Medicine
Issue number8
Publication statusPublished - 2008 Aug


All Science Journal Classification (ASJC) codes

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

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