Role of Gray Scale Ultrasound and Colour Doppler in Evaluation of Thyroid Nodules with Pathological Correlation
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 12
Abstract
Background: Nodular thyroid disease is detected in 3–7% of the adult population worldwide. Thyroid cancer is rare and accounts for <1% of all malignant neoplasms. The high prevalence of thyroid nodules in the general population calls for a clear strategy to identify patients in whom surgical excision is genuinely indicated as opposed to those who can be managed conservatively. Materials: The study was carried out on 102 patients. Patients were examined in supine position with pillow underneath the shoulders to slightly extend the neck. GE LOGIQ P5 Ultrasound, SIEMENS ACUSON X300 were used for examination. On Gray Scale, each nodule was assessed for margins, Peripheral halo, echogenicity, composition, calcification, shape, and Lymph nodes were assessed for the loss of fatty hilum. All nodules were examined by Color Doppler to describe the vascular patterns. Each ultrasound diagnosis was matched with the histopathology/FNAC results and labelled as True Positive, True Negative, False Positive and False Negative. The pathology result was considered as the final diagnosis Results: Of the 102 nodules examined, 9 were found to be malignant on pathology. Nodular thyroid disease was more common in female population as compared to male population. The malignant nodules demonstrated solid composition (sensitivity 100%, specificity 64.5%); presence of microcalcification (sensitivity 33.3%, specificity 95.7%); ill defined margins (sensitivity 33.3%, specificity 89.4%); loss of central hilum in lymph nodes(sensitivity 77.8%, specificity 71.4%) and markedly hypoechoic character (sensitivity 77.8%, specificity 95.6%). The sensitivity and specificity of Intranodular vascularity as a predictor for malignancy was 66.6% and 72.0 %. Conclusion: Since Gray scale and Colour Doppler have their own strengths and weaknesses, they are complementary rather than competitive modalities in diagnosing benign from malignant thyroid nodules. Combinations of Gray Scale, Color Doppler improve the detection of malignancy in thyroid nodules.
Authors and Affiliations
Dhruv Aggarwal
Keywords
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