ArticleJournal of medical ultrasonics (2001)2026
Clinical significance of acoustic shadowing without high-echo signal in papillary thyroid microcarcinoma.
Article in Journal of medical ultrasonics (2001), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
purposePapillary thyroid microcarcinoma (PTMC) with acoustic shadowing without a high-echo signal is occasionally encountered in clinical practice. However, the pathophysiology underlying such findings has not been investigated. We aimed to elucidate the clinical significance of acoustic shadowing without a high-echo signal in PTMC.
methodsNine PTMC nodules with acoustic shadowing but no high-echo signal and 76 PTMC nodules without acoustic shadowing or high-echo signal were included. Nodules were analyzed using ultrasound, aspiration cytology, and histological examination.
resultsPunctate echogenic foci were not observed in PTMC nodules with acoustic shadowing but no high-echo signals. The frequency (11.1%) of psammoma bodies in PTMC nodules with acoustic shadowing was lower than that in nodules without acoustic shadowing (31.6%); however, the difference was not significant. Extensive hyalinization was observed in 66.7% and 3.9% of PTMC nodules with and without acoustic shadowing, respectively (p < 0.001). The distributions of acoustic shadowing and hyalinized stroma were correlated.
conclusionsAcoustic shadowing without a high-echo signal is caused not by calcification but rather by extensive hyalinization. Our results may help refine the sonographic criteria for PTMC and provide a novel imaging marker for identifying indolent tumors, thereby supporting active surveillance strategies and potentially reducing overtreatment.
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