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B-Mode Ultrasonography in Assessment of Thyroid Gland Lesions

MURRAY MISKIN, M.D., F.R.C.P.(C); IRVING B. ROSEN, M.D., F.R.C.S.(C), F.A.C.S.; and PAUL G. WALFISH, M.D., F.R.C.P.(C), F.A.C.P.
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Presented in part 28 October 1972 at the Eastern Regional Meeting of the American College of Physicians, Hamilton, Ontario, Canada, and the Eastern Sectional Meeting of the American Federation for Clinical Research, 12 January 1973, Boston, Massachusetts.

▸Address requests for reprints to Murray Miskin, M.D., Department of Radiological Sciences, Mount Sinai Hospital, 550 University Ave., Toronto M5G1X5 Ontario.


Toronto,Canada


Ann Intern Med. 1973;79(4):505-510. doi:10.7326/0003-4819-79-4-505
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We have used B-mode ultrasonography in a study of 150 cases to differentiate between cystic and solid characteristics of thyroid nodules, properties that could not be reliably determined by palpation, X ray, or radioisotope scintiscanning. Preoperative ultrasonic diagnosis corresponded to pathological findings at follow-up in 49 of 50 solitary hypofunctioning nodules greater than 1 cm in diameter: 22% were cystic, and 78% were solid. Nine cases of proved thyroid carcinoma were indistinguishable from solid benign lesions. We suggest that solitary cystic thyroid nodules should be treated conservatively by primary needle aspiration, cytologic examination of cyst fluid, and careful follow-up observation while on exogenous thyroid hormone suppression therapy. Patients with solitary solid hypofunctioning nodules are considered to be at greater risk for underlying thyroid malignancy and may be selected for surgical extirpation, depending on other clinical features. Echography, as the initial diagnostic test before scintiscanning, provides useful information and minimizes radiation exposure.

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