Abstract
Background: Thyroid nodule imaging had been a challenging task. Ultrasound has been the modality of choice for detection & evaluation of these lesions. This study was done to identify the accuracy of various imaging features in thyroid nodules that are associated with benignity and malignancy and the overall accuracy of ultrasound in determining malignant nodules. The objective of the study are: (1) Ultrasonographic evaluation of thyroid to characterize the thyroid disease and nodules (benign vs malignant) and their morphologic evaluation. (2) Sensitivity and Specificity on the basis of radiological, and cytopathological correlation for suspected thyroid lesions. Subjects and Methods: A total of seventy patients (70) of both sexes and different age group, meeting the inclusion criterion, were the part of present prospective study. The cases referred to the Department of Radio-diagnosis and imaging from OPD/IPD of Saraswathi Institute of Medical sciences, Hapur from October’2017 to July’2019. An informed consent was taken from all the patients subjected for evaluation. Results: The collective data was analysed for Ultrasound findings of thyroid nodule which presented clinically as solitary or multiple thyroid nodules. The total number of cases analysed was 70 out of which 48 were found to have solitary/multinodular lesions clincally. On ultrasound evaluation out of 48 patients 38 had solitary/multinodular lesions. Conclusion: High resolution sonography is recommended as the primary imaging modality in evaluation of thyroid diseases. It has a high sensitivity and specificity in the diagnosis of thyroid diseases.
Highlights
Subjects and MethodsThyroid nodules are extremely common, found at palpation in 4% to 7% of an asymptomatic population, [1,2] in 17% to 27% of cases at USG, [3,4,5] and in 50% of cases at autopsy. [6] USG is the modality of choice in a clinically suspected case of thyroid lesion and the most sensitive imaging modality to detect a clinically non-palpable nodule of 2-3 mm size and allows a more accurate morphological characterization of the lesion including the size and the number of thyroid nodules, the volume of thyroid tissue and could well differentiate with extra-thyroid neck masses
Out of 48 patients with clinical suspicion of thyroid nodule, 35.4% of patients diagnosed as Solitary Thyroid Nodule clinically were found to have a multinodular thyroid disease at high resolution sonography. 21 (43.75%) patients were sonographically proven to be STN. 10 patients who clinically suspected to be STN were diagnosed as other thyroid disorders and showed no evidence of nodularity on Ultrasonography. [13,14,15]
Results of our study show that high resolution sonography had sensitivity of 96.88% and specificity of 83.33% in diagnosing thyroid lesions with a positive predictive value of 98.41% and NPV of 71.43%
Summary
Subjects and MethodsThyroid nodules are extremely common, found at palpation in 4% to 7% of an asymptomatic population, [1,2] in 17% to 27% of cases at USG, [3,4,5] and in 50% of cases at autopsy. [6] USG is the modality of choice in a clinically suspected case of thyroid lesion and the most sensitive imaging modality to detect a clinically non-palpable nodule of 2-3 mm size and allows a more accurate morphological characterization of the lesion including the size and the number of thyroid nodules, the volume of thyroid tissue and could well differentiate with extra-thyroid neck masses. [7,8] This prospective study was conducted from 1st October 2017 to 30th July’ 2019 on the cases referred from OPD/IPD of the SIMS Hospital, to the Department of Radio-diagnosis, SIMS, Hapur in collaboration with the Department of Pathology, Otolaryngology, and Surgery. This study was done to identify the accuracy of various imaging features in thyroid nodules that are associated with benignity and malignancy and the overall accuracy of ultrasound in determining malignant nodules. On ultrasound evaluation out of 48 patients 38 had solitary/multinodular lesions. Conclusion: High resolution sonography is recommended as the primary imaging modality in evaluation of thyroid diseases. It has a high sensitivity and specificity in the diagnosis of thyroid diseases
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