Can Nodular Hyperplasia of the Thyroid Gland be Differentiated From Follicular Adenoma and Follicular Carcinoma by Ultrasonography?

Objectives The aim of this study was to evaluate the ultrasonographic features for differentiation of follicular thyroid lesions. Methods Ultrasonographic features of surgically confirmed 56 follicular adenoma (FA), 22 follicular carcinoma (FC), and 100 nodular hyperplasia (NH) were evaluated using univariable and multivariable multinomial logistic regression analyses, receiver operating characteristic analyses, and areas under the curve. Results Tumor diameter, margin, echotexture, cystic changes, calcification, hypoechoic rim, and vascularity were significant on univariable analysis. On multivariable logistic regression analyses, tumor diameter (FA, P = 0.002; odds ratio [OR], 0.75; FC, P = 0.001; OR, 2.02), absence of cystic changes (FA, P = 0.127; OR, 2.21; FC, P 0.001; OR, 17.74), absence of spongiform appearance (FA, P = 0.234; OR, 0.31; FC, P < 0.001; OR, 1673.46), and peripheral vascularity (FA, P = 0.004; OR, 26.64; FC, P < 0.001; OR, 145060.38) differed significantly among the 3 follicular lesions, with NH as a reference. The areas under the curve for NH, FA, and FC were 0.844, 0.858, and 0.705, respectively, and diagnostic accuracy was 72.6%. Conclusions Tumor diameter, cystic changes, spongiform appearance, and peripheral vascularity differed significantly among follicular lesions. The diagnostic capability was moderate.