Rofo 2014; 186(5): 489-495
DOI: 10.1055/s-0034-1366282
Head/Neck
© Georg Thieme Verlag KG Stuttgart · New York

Differential Diagnostic Ultrasound Criteria of Papillary and Follicular Carcinomas: A Multivariate Analysis

Differentialdiagnostische Ultraschallkriterien papillärer und follikulärer Schilddrüsenkarzinome: Eine multivariate Analyse
M. Cordes
1   Nuremberg, Radiological and Nuclear Medical Center, Nuremberg
,
P. Kondrat
2   Department of General Radiology, Interventional Radiology and Neuroradiology, Medical University, Wroclaw
,
M. Uder
3   Department of Radiology, University Erlangen-Nuremberg, Erlangen
,
T. Kuwert
4   Department of Nuclear Medicine, University Erlangen-Nuremberg, Erlangen
,
M. Sasiadek
2   Department of General Radiology, Interventional Radiology and Neuroradiology, Medical University, Wroclaw
› Author Affiliations
Further Information

Publication History

15 April 2013

09 September 2013

Publication Date:
09 April 2014 (online)

Abstract

Purpose: The purpose of the study was to test the hypothesis that papillary thyroid carcinomas (PTCs) and follicular thyroid carcinomas (FTCs) appear with different ultrasound characteristics.

Material and Methods: 90 patients (70 females, 20 males) were included in the study in whom after thyroidectomy the diagnoses of PTCs or FTCs were established. 33 patients (25 females, 8 males) with the diagnosis of follicular adenoma were included in the study as controls (KONs). All patients had ultrasound examinations of the thyroid preoperatively. These ultrasound examinations were evaluated retrospectively with respect to the ultrasound characteristics: “size”, “shape”, “contour”, “structure”, “echogenicity” and “calcifications”.

Results: In PTCs, FTCs and KONs “size” was significantly different (PTCs: MW = 12.5 mm, SD = 8.1 mm – FTCs: MW = 35.4 mm, SD = 19.6 mm – KONs: MW = 22.7 mm, SD = 14.5 mm; p < 0.001 for PTCs vs. FTCs, p < 0.001 for PTCs vs. KONs, p = 0.013 for FTCs vs. KONs). Differences were also found with respect to “contour” and “echogenicity” among PTCs, FTCs and KONs (p ≤ 0.035). The parameters “size”, “contour”, “echogenicity” and “calcifications” correlated for PTCs, FTCs and KONs with a correlation coefficient r = 0.57 (p < 0.05, multivariate regressionanalysis).

Conclusions: PTCs and FTCs appear with different sonographic characteristics. Although there is some overlapping of the sonographic appearances of PTCs and FTCs, the knowledge of these differences should have some impact of the risk adapted further work up.

Key Points:

• In preoperative ultrasound examinations FTCs appear significantly larger than PTCs.

• The sonographically detected structure of FTCs can be classified as inhomogeneous predominantly, whilst PTCs are equally homogeneous or inhomogeneous.

• The knowledge of the different sonographic appearance of PTCs and FTCs is of importance within the context of risk-adapted further work-up.

Citation Format:

• Cordes M, Kondrat P, Uder M et al. Differential Diagnostic Ultrasound Criteria of Papillary and Follicular Carcinomas: A Multivariate Analysis. Fortschr Röntgenstr 2014; 186: 489 – 495

Zusammenfassung

Ziel: In der vorliegenden Arbeit sollte die Hypothese überprüft werden, dass sich papilläre Schilddrüsenkarzinome (PTCs) von follikulären Schilddrüsenkarzinomen (FTCs) bezüglich ihrer Ultraschallcharakteristika unterscheiden.

Material und Methoden: Untersucht wurden 90 Patienten (70 weiblich, 20 männlich), bei denen nach Thyreoidektomie histologisch die Diagnosen von PTCs oder FTCs gestellt wurde. Als Kontrollen (KONs) dienten 33 Patienten (25 weiblich, 8 männlich) mit einem follikulärem Adenom. Hochauflösende Ultraschalluntersuchungen erfolgten präoperativ mit Erfassung der Ultraschallcharakteristika: „Größe“, „Form“, „Kontur“, „Binnenstruktur“, „Echogenität“ und „Kalzifikationen“.

Ergebnisse: PTCs, FTCs und KONs unterschieden sich hinsichtlich „Größe“ (PTCs: MW = 12,5 mm, SD = 8,1 mm – FTCs: MW = 35,4 mm, SD = 19,6 mm – KONs: MW = 22,7 mm, SD = 14,5 mm; p < 0,001 für PTCs vs. FTCs, p < 0,001 für PTCs vs. KONs, p = 0,013 für FTCs vs. KONs). Auch im Hinblick auf „Kontur“ und „Echogenität“ konnten Unterschiede zwischen PTCs, FTCs und KONs gefunden werden (p ≤ 0,035). „Größe“, „Kontur“, „Echogenität“ und „Kalk“ ergaben für PTCs, FTCs und KONs einen Korrelationskoeffizienten r = 0,57 (p < 0,05, multiple Regressionsanalyse).

Schlussfolgerungen: Hinsichtlich ihres sonografischen Erscheinungsbildes gibt es Unterschiede zwischen PTCs und FTCs. Wenngleich große Überlappungen vorkommen können, erscheint die Kenntnis der Unterschiede im sonografischen Erscheinungsbild für eine risikoadaptierte Abklärungsdiagnostik von Bedeutung.

Deutscher Artikel/German Article

 
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