Pompili et al developed a simple ultrasound score for evaluating a thyroid nodule. This can help to decide if the patient should go to surgery or be followed clinically. The authors are from Azienda Ospedaliera San Paolo in Milan.
Patient selection: thyroid nodule with cytology diagnosis of follicular pattern (differential diagnosis follicular hyperplasia, follicular adenoma, follicular carcinoma)
Parameters:
(1) number of thyroid nodules
(2) margin(s)
(3) color of blood flow
(4) structure
(5) echogenicity
(6) halo
(7) calcifications
(8) growth over past 6 months
Parameter |
Finding |
Points |
---|---|---|
number of thyroid nodules |
1 |
2 |
|
>= 2 |
0 |
margin |
regular |
0 |
|
irregular |
2 |
color of blood flow |
perinodular |
0 |
|
peri- and intra-nodular |
1 |
|
intra-nodular |
2 |
structure |
colloidal |
0 |
|
solid |
1 |
echogenicity |
hypoechoic |
1 |
|
other (an-, iso-, hyper-) |
0 |
halo |
continuous |
0 |
|
discontinuous |
1 |
calcifications |
macro or none |
0 |
|
micro |
1 |
growth in 6 months |
<= 20% |
0 |
|
> 20% |
1 |
where:
• Change in size may be based on diameter, area or volume.
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 11
• The higher the score the greater the risk for carcinoma.
Score |
Malignancy |
Management |
---|---|---|
0 to 2 |
0% |
monitor |
3 |
21% |
ultrasound followup |
4 to 11 |
79% |
surgery |
Specialty: Endocrinology, Clinical Laboratory
ICD-10: ,