Portal de Periódicos da CAPES

Artigo Produção Nacional Revisado por pares

BIBTEX RIS

Predicting Malignant Involvement in a Thyroid Nodule: Role of Ultrasonography

2007; Elsevier BV; Volume: 13; Issue: 3 Linguagem: Inglês

10.4158/ep.13.3.219

1934-2403

Lúcia Helena Coelho Nóbrega, Fernando José Pinto de Paiva, Maria Lúcia Coelho Nóbrega, Luiz Eduardo Barbalho de Mello, Hermano A.F. Fonseca, Saul O. Costa, André Gustavo Pires de Sousa, Denise B.F.M. Leite, Josivan Gomes Lima,

Head and Neck Anomalies

Objective To assess how ultrasonography can contribute during the evaluation of a thyroid nodule and whether this technique can have a role in predicting malignant involvement. Methods In this retrospective study, data were analyzed on 220 consecutive patients (with 348 thyroid nodules) who underwent thyroidectomy and had previously undergone assessment by high-resolution thyroid ultrasonography. Nodule size, echogenicity, regularity of margins, halo sign, presence or absence of calcifications, and invasion of surrounding tissues were evaluated. The nodules were classified as low, medium, or high risk for malignant involvement on the basis of nodule characteristics found on ultrasonography. All nodules were submitted to cytologic examination by fine-needle aspiration (FNA) before thyroidectomy. Ultrasound, FNA, and pathologic postoperative results were compared. Results Among the 348 thyroid nodules, 56 were ultrasonographically classified as low risk, 268 as medium risk, and 24 as high risk for malignant potential. Fifty of 56 (89.3%) low-risk nodules and 213 of 268 (79.5%) medium-risk nodules were diagnosed as benign at pathologic postoperative examination. In contrast, however, only 6 of 24 (25%) high-risk nodules were diagnosed as benign. Among the 18 high-risk nodules of 1-cm diameter or larger, FNA showed a 20% false-negative result. Conclusion High-risk classification of a thyroid nodule on ultrasonography had a positive predictive value for malignant involvement of 75%. Nodule characteristics analyzed by ultrasonography should be considered at the time of surgical intervention. (Endocr Pract. 2007;13: 219-224)