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KMID : 0371319920420020156
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Journal of the Korean Surgical Society
1992 Volume.42 No. 2 p.156 ~ p.164
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Differential Diagnosis of Thyroid Nodules: The Roles of Thyroid Scintigraphy, Thyroid Ultrasonography and Fine Needle Aspiration
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Abstract
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The selection of patients with thyroid nodules for sugery is a difficult task. The traditional approaches of radionuclide and ultrasongraphy have been shown to be poorly specific in the diagnosis of malignancy. To compare the usefulnesses of
thyroid
scintigraphy, thyroid ultrasonography and fine needle aspiration biopsy in differential diagnosis of thyroid nodules, we reviewed the records of 183 patients who underwent thyroidectomy for thyroid nodules.
Thyroid carcinoma was diagnosed in 36 patients(19.7%). In this retrospective study, the incidence of thyroid carcinoma with cold nodules on thyroid scintgraphy was 16.7%, which was similar to the incidence of thyroid carcinoma with
hyperfunctioning
nodules (22.2%).
Sonographic characteristics was analized in 60 patients including 54 benign and 5 malignant nodules. Six items were examined; presence of cystic component, hypoechogenicity, heterogeneity, presence of calcification, presence of halo, and
irregular
margin. But the difference in benign and malignant nodules was not significant.
Fine needle aspiration biopsy was performed in 66 patients, and 5 of specimens provided inadequate for cytologic evaluation. The false negative rate was 9.8%(4/41), false positive rate was 14.4%(1/7), sensitivity to detect malignancy was 60.0%,
specificity to exclude malignancy was 97.4%, and diagnostic accuracy to diagnose malignancy was 89.6%.
We found that fine needle aspiration biopsy was useful to differential diagnsis of thyroid nodules, while thyroid scintigraphy and thyroid ultrasonography were not.
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KEYWORD
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