Journal
ENDOCRINE
Volume 57, Issue 2, Pages 335-343Publisher
SPRINGER
DOI: 10.1007/s12020-016-1116-1
Keywords
Hyperparathyroidism; Real-time ultrasound elastography; Thyroid nodules; Lymph nodes; Ectopic thyroid; Ultrasonography; Elastoscan (TM)
Categories
Ask authors/readers for more resources
To evaluate the accuracy of ultrasound elastography with Elastosca (TM) Core Index in the differential diagnosis of parathyroid lesions from ectopic thyroid nodules and lymph nodes. Seventy nine patients with repeatedly high levels of circulating intact parathyroid hormone, normal vitamin D and renal function tests, with an ultrasound scan showing a neck lesion, sharply demarcated from the thyroid lobules, were consecutively enrolled. Ultrasound with and without Color Doppler and ultrasound elastography were performed before histological examination. All ultrasound features, vascularization and ultrasound elastography diagnostic performance were assessed using ROC curves. Histological examination confirmed 47 parathyroid lesions, 18 thyroid ectopic nodules and 14 reactive lymph nodes. In distinguishing parathyroid from thyroid nodules, shape had a 100 % sensitivity (95 % CI 92.4-100) and 50 % specificity (95 % CI 37.2-64.7), cleavage had a 85.1 % sensitivity (95 % CI 72.3-92.6) and 77.8 % specificity (95 % CI 65.1-88) while peripheral vascularization had a sensitivity of 91.5 (95 % CI 79.6-97.6) and specificity of 72.2 (95 % CI 46.5-90.3). An Elastoscan (TM) Core Index of 1.28 was 46 % sensitive (95 % CI 33.4-58.7) and 77 % specific (95 % CI 66.2-89.1) in discriminating parathyroid lesions from thyroid nodules. An Elastoscan (TM) Core Index of 1.0 was 78 % sensitive (95 % CI 65.1-88) and 71 % specific (95 % CI 56-81.3) in discriminating parathyroid lesions from lymph nodes (p = 0.045). An Elastoscan (TM) Core Index greater than 2.58 had a 100 % sensitivity (95 % CI 43.8-100) and 95.4 % specificity (95 % CI 38.3-99.7) in discriminating malignant from benign parathyroid nodules. Elastoscan (TM) Core Index was significantly higher in thyroid nodules than in reactive lymph nodes (1.18 +/- 0.62, p = 0.008). The ultrasound features of cleavage and peripheral vascularization help to differentiate parathyroid from thyroid nodules. Elastoscan (TM) Core Index can improve ultrasound discrimination of parathyroid lesions from lymph nodes. The Elastoscan (TM) Core Index is significantly higher in malignant than in benign parathyroid lesions.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available