Sonography of thyroid nodules with peripheral calcifications

Area of Science:

• Radiology
• Oncology
• Endocrinology

Background:

• Thyroid nodules are common, and distinguishing benign from malignant types is crucial for patient management.
• Peripheral calcifications in thyroid nodules can be a sonographic finding that requires careful evaluation.

Purpose of the Study:

• To evaluate the effectiveness of sonography (US) in differentiating benign from malignant thyroid nodules characterized by peripheral calcifications.
• To identify specific sonographic features associated with malignancy in thyroid nodules with peripheral calcifications.

Main Methods:

• Retrospective analysis of 64 thyroid nodules with peripheral calcifications identified via ultrasound.
• Comparison of sonographic findings including calcification characteristics (interruption, thickening), internal echogenicity, margin, cystic changes, size, and shape between benign and malignant nodules.
• Statistical analysis using univariate and multivariate logistic regression.

Main Results:

• Interruption of peripheral calcifications was significantly more frequent in malignant nodules (84%) compared to benign ones (53%).
• Thickening of peripheral calcifications (>or=0.5 mm, >50% circumference) was also more prevalent in malignant nodules (64%) than benign (11%).
• Hypoechogenicity was a common feature in malignant nodules (58%) versus benign nodules, with significant statistical association.

Conclusions:

• Sonographic features like interrupted and thickened peripheral calcifications are indicative of malignancy in thyroid nodules.
• Decreased internal echogenicity on ultrasound is strongly associated with malignant thyroid nodules presenting with peripheral calcifications.
• These sonographic findings aid in the differential diagnosis of thyroid nodules with peripheral calcifications, guiding further management.