Sonographic differentiation of thyroid nodules with eggshell calcifications.

Area of Science:

• Radiology
• Oncology
• Endocrinology

Background:

• Thyroid nodules with eggshell calcifications present a diagnostic challenge.
• Differentiating benign from malignant nodules is crucial for appropriate patient management.

Purpose of the Study:

• To evaluate known suspicious sonographic features.
• To identify additional sonographic findings for improved differentiation of benign and malignant thyroid nodules with eggshell calcifications.

Main Methods:

• Retrospective review of 93 thyroid nodules with eggshell calcifications from 92 patients.
• Assessment of known suspicious criteria (hypoechogenicity, irregular margins, taller-than-wide shape) and additional findings (hypoechoic halo, disrupted calcification rim).
• Calculation and comparison of sensitivity and specificity for differentiating benign and malignant nodules.

Main Results:

• Malignant nodules: 59; Benign nodules: 34.
• Peripheral halo and disrupted calcification rim showed higher sensitivity (62.7%, 76.3%) than known criteria (40.7%, 35.6%, 55.9%).
• Combination of halo and disrupted rim yielded significantly higher sensitivity (93.2%) compared to known criteria (78%), with similar specificity (64.7%).

Conclusions:

• Peripheral halo and disrupted eggshell calcifications are more effective sonographic predictors of malignancy in thyroid nodules.
• These findings offer improved differentiation compared to traditional criteria like hypoechogenicity, microlobulated margins, and taller-than-wide shape.