Endocrine Abstracts

Methods of radiation diagnostics and fine needle aspiration biopsy (FNAB) are the methods of the first stage of diagnosis of thyroid nodules, which is confirmed by a large number of international recommendations. However, these methods do not always give the right answer for thyroid adenomas. The aim of the study was to study the effectiveness of a set of methods: ultrasound, sonoelastography, scintigraphy and FNAB in the diagnosis of thyroid adenomas. The study included 86 patients with a morphologically confirmed diagnosis of thyroid adenomas. The patients underwent ultrasound (86) and FNAB (86), sonoelastography (55) and scintigraphy (37). The results of a multiparametric ultrasound examination showed that the images of the adenomas do not correspond to standard estimates. There are also no ultrasound signs that are the ‘key to diagnosis‘. Signs of ‘border‘, ‘contour‘, ‘height less than width‘ were characteristic of most benign nodules of various structures. Signs of ‘solid structure‘ and ‘increased blood flow‘ have also been found in thyroid cancer. Discriminant analysis showed that the signs of ‘borders‘, ‘contours‘, ‘halo‘ and the absence of ‘calcification‘ are the ‘reference‘ signs of thyroid adenomas. The estimate according to EU-TIRADS was: EU-TIRADS2 -20.3%, EU-TIRADS3 - 5.3%, EU-TIRADS4 - 72.5%, EU-TIRADS5 - 1.9%. The efficiency parameters of EU-TIRADS were 86.9% sensitivity, 73.5% specificity and 80.2% accuracy. Cytological examination showed results with a significant spread: TBSRTC1 - 8.5%, TBSRTC2-13.1%, TBSRTC3-15.1%, TBSRTC4 -48.5%, TBSRTC5 - 13.5%, TBSRTC6 - 1.3%. According to sonoelastography data, images of thyroid adenomas demonstrated low probability of malignant process: 1 (41.8%) and 2 patterns (54.5%). The Young’s modulus index was 23.5±7.1 kPa, but in some cases the values exceeded 45 kPa. Elastography in thyroid adenomas has a sensitivity of 96.4%, specificity of 57.1% and accuracy of 88.41%. Elastography of thyroid adenomas showed better indicators than in the EU-TIRADS. However, when studying e, it was found that taking into account only e data can lead not only to the absence of thyroid cancer cases, but also to erroneous conclusions in a. In thyroid adenomas scintigraphy, sensitivity was 53.3%, specificity - 42.3%, accuracy - 44.7%. However, the possibilities of this method are mainly limited to hyperfunctional nodules, which is observed in adenomas only in half of cases. Based on the data obtained, the concept of the need for regulation (sequence) of the complex phased application of methods of radiation diagnostics and cytological examination in the examination of patients is formulated.