Association of Sonographic Features of Unifocal Papillary Thyroid Carcinoma With Cervical Lymph Node Metastasis

Background Papillary thyroid carcinoma (PTC) is the most common pathological type of thyroid carcinoma. We aim to evaluate the association of sonographic features of PTC and cervical lymph node metastasis (CLNM) at the initial surgery. Methods Clinical information, ultrasonographic measurements and features for 1335 patients were acquired in data collection. Univariate analysis was performed to test CLNM by 7 independent variables. Receiver operating characteristic (ROC) curve was created to evaluate the diagnostic performance. Results Univariate analysis showed that gland, location, aspect ratio, margin and echogenic foci were independently associated with CLNM metastatic status (P<0.05). Binary linear regression analysis showed that sex, age, tumour maximum diameter and volume, location, margin and echogenic foci were independent correlative factors. The ROC curves were established based on the relevant factors, the AUC of tumour maximum diameter, tumour volume and margin were 0.74, 0.73, and 0.71, respectively. The multiple-variable linear regression model was constructed with AUC of 0.81, specificity of 72.8%, and sensitivity of 75.0%. ANOVA variance analysis for sub-positive groups, tumour maximum diameter, tumour volume, margin and echogenic foci had statistical significance (P<0.05).Conclusion Younger age, male, larger tumour, margin, and echogenic foci were high risk factors for CLNM in PTC. Cross-sectional aspect ratio with value≥1 had higher predictive value for CLNM in patients with larger thyroid tumors.

Thyroid Imaging Reporting And Data System (TIRADS) For Ultrasound Features Of Solitary Thyroid Nodules

Purpose to investigate the Thyroid Imaging Reporting and Data System (TIRADS) as a new classification system for solitary thyroid nodules by high resolution Ultrasonography in correlation with histopathological study. Materials and Methods Thirty patients with clinically suspected thyroid nodules referred to Radiology department at Ain shams University hospitals after fulfilling inclusion and exclusion criteria. All thyroid nodules are examined by ultrasound and charactrized according to internal components, margins, echogenicity, shape and evidence of echogenic foci the classified according to the American college of radiology (ACR) TIRADS guidline, then compared with histopathological examination by Fine needle aspiration cytology (FNAC) . Results Many ultrasound features were predeictors of malignancy hypoechoic echopattern, taller than wider shape, punctate echogenic foci, and lobulated and irregular margins with (p &lt; 0.05). Risk of malignancy on TIRADS 1 and 2 nodules were 0%, also on TIRADS 3 nodules was 0%. While on TIRADS 4 and 5 nodules were 11.1% and 88.9% respectively. ROC analysis revealed sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under curve (AUC) are 100, 85.71, 75.00, 100.00 and 0.987 respectively when using cut-off value of score &lt;5. Conclusion Our results suggest that ACR TIRADS classification is reliable in predicting thyroid malignancy. It could lead to a significant decrease of the number of unnecessary FNAC.

Association of Sonographic Features of Unifocal Papillary Thyroid Carcinoma With Cervical Lymph Node Metastasis

Background Papillary thyroid carcinoma (PTC) is the most common pathological type of thyroid carcinoma. We aim to evaluate the association of sonographic features of PTC and cervical lymph node metastasis (CLNM) at the initial surgery.Methods Clinical information, ultrasonographic measurements and features for 1335 patients were acquired in data collection. Univariate analysis was performed to test CLNM by 7 independent variables. Receiver operating characteristic (ROC) curve was created to evaluate the diagnostic performance.Results Univariate analysis showed that gland, location, aspect ratio, margin and echogenic foci were independently associated with CLNM metastatic status (P < 0.05). Binary linear regression analysis showed that sex, age, tumour maximum diameter and volume, location, margin and echogenic foci were independent correlative factors. The ROC curves were established based on the relevant factors, the AUC of tumour maximum diameter, tumour volume and margin were 0.74, 0.73, and 0.71, respectively. The multiple-variable linear regression model was constructed with AUC of 0.81, specificity of 72.8%, and sensitivity of 75.0%. ANOVA variance analysis for sub-positive groups, tumour maximum diameter, tumour volume, margin and echogenic foci had statistical significance (P < 0.05).Conclusion Younger age, male, larger tumour, margin, and echogenic foci were high risk factors for CLNM in PTC. Cross-sectional aspect ratio with value ≥ 1 had higher predictive value for CLNM in PTC patients excluding papillary thyroid microcarcinoma (PTMC).

Ultra-High-Frequency Ultrasound in the Evaluation of Paediatric Pilomatricoma Based on the Histopathologic Classification

Background: Pilomatricoma (PM) is one of the most common benign tumours in children. However, the inaccuracy of preoperative diagnosis and evaluation is high. Non-invasive examinations, including dermoscopy and ultrasound are helpful for diagnosing and evaluating PM. To date, ultra-high-frequency ultrasonographic features of PM have been rarely studied.Objective: We aimed to investigate the ultra-high frequency ultrasonographic features of PM in a large paediatric cohort and to determine the associations of these features with the clinical features of different histological subtypes of PM.Methods: This was a retrospective study. Patients who had both preoperative ultra-high-frequency ultrasonographic evaluation and pathological diagnosis of PM were enrolled. A series of infantile haemangiomas and cutaneous cysts during the same period were included as controls. Histological findings, including the stage, calcifying type, and ultrasonographic features of each lesion, were described.Results: A total of 133 patients with PM were included, and 147 PM lesions were analysed. The male-to-female ratio was 1:1.58, and the median age of onset was 91 (range: 10–188) months. On ultra-high-frequency ultrasonography, PM presented as heterogeneous (144/147, 98.0%), well-demarcated (143/147, 97.3%), and hypoechoic (126/147, 85.7%) tumours located between the deep dermis and subcutaneous tissue (139/147, 94.6%). The most common features were internal echogenic foci (135/147, 91.8%), hypoechoic rim (133/147, 90.5%), and posterior acoustic shadowing (94/147, 63.9%). Fourteen (9.5%) lesions were histologically categorized in the early stage, 58 (39.5%) in the fully developed stage, 65 (44.2%) in the early regressive stage and 10 (6.8%) in the late regressive stage. Three calcifying types, including scattered dots, clumps and arcs, were observed on histologic examination, which corresponded well with grey-scale imaging on ultra-high-frequency ultrasonography. Each calcifying type was significantly different in various histological stages (P = 0.001), among which scattered dots were mainly present in the early and fully developed stage and arc-shaped calcifying were present in the regressive stages. Calcification was observed in skin cysts, while there was more frequent posterior enhancement, less frequent posterior shadowing, and hypoechoic rim than PM. Haemangioma also presented as a hypoechoic tumour on grey-scale imaging. However, haemangioma was homogeneous and rarely calcifying.Conclusions: PM is a heterogeneous, well-demarcated, hypoechoic tumour located between the deep dermis and the subcutis on ultra-high-frequency ultrasonography. The most common features are internal echogenic foci (calcifying) and hypoechoic rim. Calcifying types can help in the staging of PM. Ultra-high-frequency ultrasound is a useful tool for the diagnosis and evaluation of PM.

Assessment the Adherence of Radiologists to the Thyroid Imaging Reporting and Data System (TIRADS)

Introduction: Thyroid nodules are the most common findings among adults. Usually, Fine Needle Aspiration Biopsy (FNAB) can be used to distinguish the malignant and benign lesions. Application of a non-invasive method for determining the chance of malignancy in a nodule is desirable. Thyroid Imaging Reporting and Data System (TIRADS) was introduced to decrease the unnecessary FNABs and to optimize the management of these patients. The objective of this study was to assess the adherence of radiologist’s reports to TIRADS, after 10 years from the introduction of this system to radiologists in Fars Province. Methods: In this retrospective study, sonography report of the patients, who were referred to hospital for FNAB was assessed. If the patients did not have the previous sonography reports or the report was unreadable, they would be excluded from the study. Composition, echogenicity, shape, size, and margin were assessed and scored in this study. As the reports noted to each of the above-mentioned issues, score 1 was assigned to them. SPSS version 15 was used to analyze the data and calculated the standard deviation. Results: Sonography reports of 111 out of 250 patients was evaluated. The mean score of sonography reports from 5 was 2.63±0.86. The percentage of adherence of sonography reports to the expression of the first five categories was 52.61±17.25 %. Echogenic foci were also evaluated in the patients that it existed. The radiologists were reported them in almost 81% of cases. Conclusion: Overall adherence of sonographic report to TIRADS was 57.34%. The adherence can be definitely improved by training the radiologists.