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Category: Volume 06 Issue 10 October 2018
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Title: Role of High Frequency Ultra-Sonogram & Color Duplex Findings with FNAC in Identifying Benign and Malignant Thyroid Nodule

Authors: Dr V Sridhar, Dr M Adaikkappan, Dr M. Dhanalakshmi

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i10.146

Abstract

Introduction: High frequency ultra-sonogram is the best imaging investigation accessible, for the analysis of the thyroid tissue and because of frequent use of ultra-sonogram non palpable thyroid nodules were also identified before symptoms. In this present study I am correlating ultra sound B-Mode grayscale, color and spectral Doppler characteristics of benign versus malignant thyroid nodules with FNAC findings.

Aim: To study the specific B – mode grayscale characteristics, color Doppler and standard reference values of Doppler Resistive index of benign versus malignant thyroid nodules with that of FNAC findings. To assess the specificity and sensitivity of grayscale, color Doppler and FNAC elucidated criteria in differentiating benign from malignant nodules.

Materials and Methodology: We prospectively investigated 60 patients who were referred to our department for thyroid ultra sound investigation from various departments of our institute for thyroid swelling. Every nodule was assessed according to shape, margins, number, echo texture, halo, calcification on grey scale findings and vascularity, RI values on color Doppler findings. All nodules are designated as benign and malignant on the basis of grey scale USG and color Doppler usg findings. Cut off RI values for benign and malignant thyroid nodules by using Receiver operating characteristics curve.

Results: Based on the high frequency ultra-sonogram and color Doppler findings with cross verification with FNAC findings it was found out that out of 60 patients 40 benign, 4 malignant, 15hashimotos thyroiditis and 1 nonspecific thyroiditis. Significant correlation was noted with malignant nodule with following ultra –sonogram features of taller than wider shape, ii-defined margin, markedly hypoechoic, and micro calcification. significant intranodular vascularity and RI values >0.75 was feature of malignant nodules whereas benign nodule showed both intra and peri nodular vascularity and RI values <0.75.high sensitivity and specificity  of diagnosing  malignant nodule combining  both high frequency ultra-sonogram and color Doppler than done either of them alone.

Conclusion: Both high frequency ultra-sonogram and color Doppler findings of thyroid nodule are complimentary in diagnosing malignant and benign nature rather than either of them alone.

Keywords: USG-Ultra-sonogram, FNAC-Fine needle aspiration cytology.

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Corresponding Author

Dr V Sridhar

Resident, Department of Radio-diagnosis, Rajah Muthiah Medical College and Hospital, Annamalai University, Chidambaram