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
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