Abstract
Abstract
Purpose
The pyramidal lobe (PL) is an ancillary lobe of the thyroid gland that can be affected by the same pathologies as the rest of the gland. We aimed to assess the diagnostic performance of high-resolution sonography in the detection of the PL with verification by dissection and histological examination.
Methods
In a prospective, cross-sectional mono-center study, 50 fresh, non-embalmed cadavers were included. Blinded ultrasound examination was performed to detect the PL by two investigators of different experience levels. If the PL was detected with ultrasound, dissection was performed to expose the PL and obtain a tissue sample. When no PL was detected with ultrasound, a tissue block of the anterior cervical region was excised. An endocrine pathologist microscopically examined all tissue samples and tissue blocks for the presence of thyroid parenchyma.
Results
The prevalence of the PL was 80% [40/50; 95% CI (68.9%; 91.1%)]. Diagnostic performance for both examiners was: sensitivity (85.0%; 42.5%), specificity (50.0%; 60.0%), positive predictive value (87.2%; 81.0%), negative predictive value (45.5%; 21.0%) and accuracy (78.0%; 46.0%). Regression analysis demonstrated that neither thyroid parenchyma echogenicity, thyroid gland volume, age nor body size proved to be covariates in the accurate detection of a PL (p > .05).
Conclusion
We report that high-resolution ultrasound is an adequate examination modality to detect the PL. Our findings indicate a higher prevalence than previously reported. Therefore, the PL may be regarded as a regular part of the thyroid gland. We also advocate a dedicated assessment of the PL in routine thyroid ultrasound.
Funder
Medical University of Vienna
Publisher
Springer Science and Business Media LLC
Subject
Endocrinology,Endocrinology, Diabetes and Metabolism
Reference30 articles.
1. Braun EM, Windisch G, Wolf G et al (2007) The pyramidal lobe: clinical anatomy and its importance in thyroid surgery. Surg Radiol Anat 29:21–27. https://doi.org/10.1007/s00276-006-0165-1
2. Ranade AV, Rai R, Pai MM et al (2008) Anatomical variations of the thyroid gland: possible surgical implications. Singapore Med J 49:831–834
3. Ozgur Z, Celik S, Govsa F et al (2011) Anatomical and surgical aspects of the lobes of the thyroid glands. Eur Arch Otorhinolaryngol 268:1357–1363. https://doi.org/10.1007/s00405-011-1502-5
4. Prakash, Rajini T, Ramachandran A et al (2012) Variations in the anatomy of the thyroid gland: clinical implications of a cadaver study. Anat Sci Int 87:45–49. https://doi.org/10.1007/s12565-011-0115-9
5. Milojevic B, Tosevski J, Milisavljevic M et al (2013) Pyramidal lobe of the human thyroid gland: an anatomical study with clinical implications. Rom J Morphol Embryol 54:285–289
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