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Comparison between Ultrasonography and Computed Tomography for Detecting the Pyramidal Lobe of the Thyroid Gland: A Prospective Multicenter Study

  • Kim, Dong Wook (Department of Radiology, Busan Paik Hospital, Inje University College of Medicine) ;
  • Jung, So Lyung (Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Jinna (Department of Radiology, Severance Hospital, Yonsei University College of Medicine) ;
  • Ryu, Ji Hwa (Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine) ;
  • Sung, Jin Yong (Department of Radiology, Thyroid Center, Daerim St. Mary's Hospital) ;
  • Lim, Hyun Kyung (Department of Radiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine)
  • 투고 : 2014.10.20
  • 심사 : 2014.12.04
  • 발행 : 2015.04.01

초록

Objective: To compare the detection rates of the pyramidal lobe of the thyroid gland (TPL) using ultrasonography (US) and computed tomography (CT) in a prospective multi-center study. Materials and Methods: We enrolled 582 patients who underwent neck CT at six institutions. Each radiologist prospectively evaluated the presence and features of TPLs on thyroid US. Radiologists were divided into two groups according to their previous experience in detecting TPL on US or CT. The same radiologist also retrospectively assessed CT findings, blinded to the corresponding US findings. Results: The pyramidal lobe of the thyroid glands were detected in 230 cases (39.5%) on US and in 276 cases (47.6%) on CT. The TPL detection rate at the six institutions ranged from 22.0% to 59% for US and from 34.1% to 59% using CT. There were significant differences between US and CT in the detection rate, length, anteroposterior diameter, volume, and superior extent of TPL (p ${\leq}0.027$). The TPL detection rates on both US and CT (p < 0.001) differed significantly according to the experience level of the radiologists. When the CT result was used as a reference standard, the sensitivity, specificity, positive and negative predictive values, as well as the accuracy of US for TPL detection were 72.6%, 91.5%, 89.3%, 77.3%, and 82.1%, respectively. Conclusion: Our prospective multicenter study revealed that US could detect TPL with relatively high diagnostic accuracy compared to CT. Because the detection rate of TPL varied significantly according to the radiologists' level of experience, careful inspection is necessary to avoid imaging pitfalls and ensure appropriate evaluation of TPL on both US and CT.

키워드

참고문헌

  1. Braun EM, Windisch G, Wolf G, Hausleitner L, Anderhuber F. The pyramidal lobe: clinical anatomy and its importance in thyroid surgery. Surg Radiol Anat 2007;29:21-27 https://doi.org/10.1007/s00276-006-0165-1
  2. Sultana S, Mannan S, Ahmed M, Rahman M, Khan M, Khalil M. An anatomical study on pyramidal lobe of thyroid gland in Bangladeshi people. Mymensingh Med J 2008;17:8-13
  3. Ranade AV, Rai R, Pai MM, Nayak SR, Prakash, Krisnamurthy A, et al. Anatomical variations of the thyroid gland: possible surgical implications. Singapore Med J 2008;49:831-834
  4. Geraci G, Pisello F, Li Volsi F, Modica G, Sciume C. The importance of pyramidal lobe in thyroid surgery. G Chir 2008;29:479-482
  5. Joshi SD, Joshi SS, Daimi SR, Athavale SA. The thyroid gland and its variations: a cadaveric study. Folia Morphol (Warsz) 2010;69:47-50
  6. Zivic R, Radovanovic D, Vekic B, Markovic I, Dzodic R, Zivaljevic V. Surgical anatomy of the pyramidal lobe and its significance in thyroid surgery. S Afr J Surg 2011;49:110, 112, 114 passim
  7. Ozgur Z, Celik S, Govsa F, Ozgur T. Anatomical and surgical aspects of the lobes of the thyroid glands. Eur Arch Otorhinolaryngol 2011;268:1357-1363 https://doi.org/10.1007/s00405-011-1502-5
  8. Pacini F, Schlumberger M, Harmer C, Berg GG, Cohen O, Duntas L, et al. Post-surgical use of radioiodine (131I) in patients with papillary and follicular thyroid cancer and the issue of remnant ablation: a consensus report. Eur J Endocrinol 2005;153:651-659 https://doi.org/10.1530/eje.1.02014
  9. Park JY, Kim DW, Park JS, Kang T, Kim YW. The prevalence and features of thyroid pyramidal lobes as assessed by computed tomography. Thyroid 2012;22:173-177 https://doi.org/10.1089/thy.2011.0397
  10. Kim DW, Jung SL, Baek JH, Kim J, Ryu JH, Na DG, et al. The prevalence and features of thyroid pyramidal lobe, accessory thyroid, and ectopic thyroid as assessed by computed tomography: a multicenter study. Thyroid 2013;23:84-91 https://doi.org/10.1089/thy.2012.0253
  11. Kim KS, Kim DW, Sung JY. Detection of thyroid pyramidal lobe by ultrasound versus computed tomography: a single-center study. J Comput Assist Tomogr 2014;38:464-468 https://doi.org/10.1097/RCT.0000000000000054
  12. Kim DW, Ha TK, Park HK, Kang T. Sonographic detection of thyroid pyramidal lobes before thyroid surgery: a prospective single-center study. J Ultrasound Med 2014;33:239-244 https://doi.org/10.7863/ultra.33.2.239
  13. Ryu JH, Kim DW, Kang T. Pre-operative detection of thyroid pyramidal lobes by ultrasound and computed tomography. Ultrasound Med Biol 2014;40:1442-1446 https://doi.org/10.1016/j.ultrasmedbio.2014.01.010
  14. Torlontano M, Attard M, Crocetti U, Tumino S, Bruno R, Costante G, et al. Follow-up of low risk patients with papillary thyroid cancer: role of neck ultrasonography in detecting lymph node metastases. J Clin Endocrinol Metab 2004;89:3402-3407 https://doi.org/10.1210/jc.2003-031521
  15. Iida Y, Konishi J, Harioka T, Misaki T, Endo K, Torizuka K. Thyroid CT number and its relationship to iodine concentration. Radiology 1983;147:793-795 https://doi.org/10.1148/radiology.147.3.6844615
  16. Frates MC, Benson CB, Charboneau JW, Cibas ES, Clark OH, Coleman BG, et al. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Radiology 2005;237:794-800 https://doi.org/10.1148/radiol.2373050220
  17. Moon WJ, Baek JH, Jung SL, Kim DW, Kim EK, Kim JY, et al. Ultrasonography and the ultrasound-based management of thyroid nodules: consensus statement and recommendations. Korean J Radiol 2011;12:1-14 https://doi.org/10.3348/kjr.2011.12.1.1
  18. Ogawa C, Kammori M, Onose H, Yamada E, Shimizu K, Yamada T. Follicular carcinoma arising from the pyramidal lobe of the thyroid. J Nippon Med Sch 2009;76:169-172 https://doi.org/10.1272/jnms.76.169

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