Size Dependent Ultrasound Characteristics in Histologically Confirmed Papillary Thyroid Carcinomas: A Multivariate Analysis

Michael Cordes1, 2, 4, *, Pawel Kondrat4, Karen Horstrup2, Torsten Kuwert1, 3, Marek J. Sasiadek4
1 Projektgruppe Schilddrüsentumore, Tumorzentrum Universität Erlangen-Nürnberg, Germany
2 Radiologisch-Nuklearmedizinisches Zentrum, Nürnberg, Germany
3 Klinik für Nuklearmedizin, Universität Erlangen-Nürnberg, Germany
4 Department of Radiology, Medical University, Wroclaw, Poland

© 2012 Cordes et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Radiologisch- Nuklearmedizinisches Zentrum Martin-Richter-Strasse 43 90489 Nuremberg Germany; Tel: +49 911 5860148; Fax: +49 911 5860171; E-mail:



Epidemiologic data revealed an increasing incidence of papillary carcinomas (PTCs) in the German population. There is some evidence that the size of resected PTCs has decreased during the last few years.


The aim of the present study was to test the hypothesis that the sonographic characteristics of PTCs vary with size.


Consecutive PTCs were histologically confirmed in 41 patients. Ultrasound examinations of these 50 PTCs were reevaluated retrospectively and classified according to five sonographic criteria.


It could be shown that the sonographic shape (p < 0.001), the contour (p = 0.024), the structure (p = 0.04), the echogenicity (p < 0.001) and calcifications (p = 0.008) varied with the size of the neoplasms. By factoranalysis a factor FPTC with an eigenvalue of 1.89 could be extracted from the data on which the sonographic structure, the ontour and the presence of calcifications had the strongest impact with factorloadings of 0.74, 0.68 and 0.61, respectively.


The knowledge of the variation of the ultrasound characteristics should be of assistance for the sonographic classification of PTCs. In this context microcarcinomas usually do not display cystic components. However, they may show microcalcifications. Cystic components, hyperechogenicity and the taller-than-wide sign are predominantly seen in larger PTCs.

Keywords: Papillary thyroid carcinoma, ultrasound, thyroid neoplasia, irregular border, hypoechogenicity.