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© 2003 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 22:5-12 • 0278-4297

Tissue Harmonic Imaging of Thyroid Nodules

Initial Experience

Kazimierz T. Szopinski, MD, Maciej Wysocki, MD, Anna M. Pajk, MD, Rafal Z. Slapa, MD, Wieslaw Jakubowski, MD and Malgorzata Szopinska, MD

Department of Diagnostic Imaging, Second Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland (K.T.S., A.M.P., R.Z.S., W.J., M.S.); and Department of Pathology, Center of Medical Postgraduate Education, Warsaw, Poland (M.W.).

Address correspondence and reprint requests to Kazimierz T. Szopinski, MD, Department of Diagnostic Imaging, Second Faculty of Medicine, Medical University of Warsaw, ulica Kondratowicza 8, 03-242 Warsaw, Poland.

Objective. To determine the impact of tissue harmonic imaging on visualization of the thyroid and gray scale contrast between thyroid nodules and adjacent thyroid parenchyma. Methods. A prospective study was performed on 144 patients (148 lesions) undergoing sonographically guided fineneedle biopsy. The fundamental frequency and tissue harmonic images were obtained on a scanner with a wideband 7.5-MHz linear probe. One hundred forty-two benign nodules, 2 papillary carcinomas, 1 anaplastic carcinoma, and 1 metastatic lesion were found. In 1 case a suggestion of a follicular carcinoma was raised, and in 1 case no diagnostic material was obtained. The gray scale intensity of the lesions and adjacent thyroid tissue was measured with graphics software, and the gray scale contrast between lesions and adjacent thyroid tissue was calculated. Additionally, the overall conspicuity and border definition were evaluated by 2 independent observers. Results. Tissue harmonic imaging improved the gray scale contrast between thyroid nodules and adjacent thyroid parenchyma in 116 lesions (78.4%). The overall conspicuity and border definition were improved or equal in the harmonic mode for most lesions. Conclusions. The tissue harmonic imaging technique used as an adjunct to conventional thyroid sonography may improve lesion detectability and characterization.

Key Words: sonography • thyroid • thyroid nodules • tissue harmonic imaging

Abbreviations: ROI, region of interest • THI, tissue harmonic imaging




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