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Purpose To investigate the pathological entities of punctate echogenic foci (PEF) by correlating PEF with histopathological features of papillary thyroid carcinoma (PTC). Methods: This study included 121 consecutive patients who had undergone thyroidectomy for PTC. The inclusion criterion was entire tumor resection with a 3‐mm thickness for histopathological examination. We assessed the presence and number (<5 or ≥5) of PEF defined as punctate hyperechoic foci within the solid component of nodules. All surgical tumor specimens were retrospectively reviewed for the presence of microcalcifications, including the psammomatous calcification, coarse microcalcification, and micro‐ossification, and inspissated colloid. Results: PEF were detected in 71 (58.7%) PTCs. Psammomatous calcifications, coarse microcalcifications, and inspissated colloids were more frequently found in PTCs with PEF than in those without (74.6%, 42.3%, and 46.5%, respectively, p ≤ 0.024). Any type of microcalcification was found in 90.1% of PTCs with PEF. Psammomatous calcifications, coarse microcalcifications, and inspissated colloids were independently associated with PEF (p ≤ 0.012). Psammomatous calcifications were found in all PTCs with a high number (≥5) of PEF. Conclusion: Microcalcifications were found in most PTCs with PEF and psammomatous calcification was the main pathological entity of PEF in PTC. Our study validates reliability of PEF as a predictor of microcalcifications in PTC. [ABSTRACT FROM AUTHOR]

Purpose: This study was performed to examine the ultrasonography (US) features of normal parathyroid glands (PTGs) that were identified on preoperative US and subsequently confirmed during thyroid surgery., Methods: This retrospective study included a consecutive sample of 161 patients (mean±standard deviation age, 56±14 years; 128 women) with 294 normal PTGs identified on preoperative US PTG mapping and confirmed during thyroidectomy. A presumed normal PTG on US was defined as a small, round to oval, hyperechoic structure in the central neck. These presumed normal PTGs, as identified on preoperative US, were mapped onto thyroid computed tomography images and diagrams of the thyroid gland and neck. During the preoperative real-time US examinations, the location, size, shape, echogenicity, echotexture, and intraglandular vascular flow of the identified presumed PTGs were assessed. These characteristics were compared between superior and inferior PTGs using the generalized estimating equation method., Results: The typical US features of homogeneous hyperechogenicity without intraglandular vascular flow were observed in 267 (90.8%) normal PTGs, while atypical features, including isoechogenicity (1.0%), heterogeneous echotexture with focal hypoechogenicity (5.8%), and intraglandular vascular flow (3.7%), were noted in 27 (9.2%). Inferior PTGs were more frequently identified in posterolateral (36.1% vs. 5.3%) and thyroid pole locations (29.9% vs. 5.3%), and less frequently in posteromedial locations (29.2% vs. 88.0%), compared to superior PTGs (P&lt;0.001 for each comparison)., Conclusion: Most normal PTGs displayed the typical US features of homogeneous hyperechogenicity without intraglandular vascular flow. However, in rare cases, normal PTGs exhibited atypical features, including isoechogenicity, heterogeneous echotexture with focal hypoechogenicity, and intraglandular vascular flow.

OBJECTIVE. The purposes of this study were to identify the similarities and differences among the Korean Thyroid Imaging Reporting and Data System (TIRADS), American College of Radiology (ACR) TI-RADS, and European TIRADS and to compare the diagnostic performance of sonographic fine-needle aspiration (FNA) criteria for detecting malignant thyroid nodules. MATERIALS AND METHODS. This study included 2274 consecutively evaluated thyroid nodules 1 cm or larger in 1836 patients with final diagnoses from January 2011 to December 2016. US features of the nodules were retrospectively reviewed and classified according to three published guidelines from international societies. We compared the US lexicons, categories, and diagnostic performance of the FNA criteria for malignant nodules among the three reporting systems. RESULTS. Of the 2274 thyroid nodules, 1974 (86.8%) were benign and 300 (13.2%) were malignant; 93.7% of all malignancies were papillary carcinoma. Most of the US lexicons were similar among the three systems except for the definition of echogenicity of a nodule of mixed echogenicity in European TIRADS. Although the categories had strong correlations ( r = 0.777-0.877, all p < 0.001) among the three systems, significant differences were observed in categories 5, 4, and 3 of nodules (all p < 0.001) and in the sensitivity, specificity, and rate of unnecessary FNA of the FNA criteria for malignancy (all p < 0.001). CONCLUSION. Although the three systems had similarities in most US lexicons, significant differences were observed in the classified categories and diagnostic performance of the FNA criteria for malignancy.