Background: Microcalcifications (aggregated with psammoma bodies), detected by ultrasound (US), are the most specific feature of papillary thyroid cancer (PTC). Using B-flow imaging (BFI), we identified a new sign the (the twinkling sign; BFI-TS) in 'suspect' PTC nodules, which appeared to be generated by microcalcifications. Objective: To evaluate whether the BFI-TS was predictive of malignancy, we correlated the BFI-TS with the results of fine needle aspiration cytology and histology. Design: Cross-sectional cohort study from September 2006 to April 2008. Setting: Department of Radiology and Endocrinology, University of Naples Federico II, and Department of Endocrinology, Second University of Naples. Patients: A total of 306 consecutive patients with 539 thyroid nodules > 8 mm in diameter. Main outcome measure: US and BFI examinations were performed with the Logiq 9 system (General Electric Company, Milan, Italy); all patients underwent cytological examination. Results: Cytology revealed 455 (84.4%) beningn nodules and 84 (15.6%) malignant nodules; the latter were confirmed by postsurgical histological examination (76 cases of PTC, 7 follicular carcinoma, and 1 Hurthle cell carcinoma). All suspect nodules, namely, nodules with potential predictors of thyroid malignancy (e.g., microcalcifications and intra-nodal vascularity), were analyzed by cytology or histology (or both). Of 84, 68 (80.9%) of malignant nodules had >= 4 or more BFI-TSs in at least one scan versus only 12 of 455 (2.6%) of beningn lesions. Conclusions: Our results indicate that the BFI-TS could be reliable diagnostic technique in the management of suspect thyroid nodules.
|Digital Object Identifier (DOI):||10.1530/EJE-07-0891|
|Codice identificativo ISI:||000260169900013|
|Codice identificativo Scopus:||2-s2.0-54049120594|
|Appare nelle tipologie:||1.1 Articolo in rivista|