Endocrine Abstracts

Thyroid calcifications are a difficult problem to interpret. The deposition of calcium salt crystals often indicates profound morphological changes, cell death, their rearrangement and dedifferentiation. The calcifications are not guaranteed markers of any process. There is also no data on the effect calcifications on the development of a process in the thyroid. The analysis of 67 thyroid nodules, in wich calcifications were detected during ultrasound. Macrocalcifications were detected in 44 cases. They were ring-shaped, lumpy, amorphous, and had an acoustic shadow, the density of which depended on the sizes of the calcifications. Macrocalcifications were clearly detected during clinical examination and surgery in 35 patients. In this cases the biopsy was difficult, since calcifications was an obstacle to the needle, and the acoustic shadow does not allow registering the position of the needle tip. The 13 patients with coarse calcifications had a wide acoustic shadow covering a large volume of the nodules, which did not allow to determine their sizes and the echostructure of the central part. Microcalcifications were detected in 19 cases. The results of the biopsy: 47 patients had thyroid tumors (39 – cancer, 8 – adenomas), 20 – nodular colloidal goiter. Factor analysis revealed that in the group with macrocalcifications, tumor were detected in 59,1%, colloidal goiter in 36,4%. In the group with microcalcifications, tumors were detected in 89,5%, and colloidal goiter in 10,5%. The analysis also found that the detection by ultrasound of a combination of signs of nodules such as hypoechogenicity, blurred contours and “height more than width” (TI-RADS4-5) with a high probability indicates of a tumor and the need for biopsy. The detection of macrocalcifications, a liquid component, Halo rim, and reduced peripheral blood flow in the nodules is more typical for colloidal goiter. However, the presence of calcifications causes high rigidity of such nodules during elastography, which translates these cases into the TI-RADS4 group, in which a biopsy is absolutely indicated. In the group of tumors, macrocalcifications were detected in 55,3%, and microcalcifications in 36,2%. In colloidal goiter, macrocalcifications were detected in 80,0%, and microcalcificatoins in 10,0%. It was also found that the presence of calcifications does not affect the functional activity of the thyroid. Based on this, we can say that the presence of microcalcifications, along with reduced echogenicity and fuzzy contours of the nodules, is one of the key signs of a thyroid tumor. Colloidal goiter is more characterized by ring-shaped and lumpy macrocalcifications.