Abstract
Background: High-resolution ultrasonography is a very sensitive imaging modality for examination of the thyroid gland and associated abnormalities. It is noninvasive, widely available, less expensive, and does not use any ionizing radiation. Further, real time ultrasound imaging helps to guide diagnostic and therapeutic interventional procedures (FNAC and Biopsy) in cases of thyroid disease. Objectives: To study the diagnostic accuracy of ultrasound criteria’s for the depiction of benign or malignant thyroid nodule and their correlation with cytology or histopathology. Subjects and Methods: The study included 50 patients who were referred for ultrasound with clinical suspicion of thyroid lesions. The ultrasound diagnosis was compared to the final diagnosis made on cytology or histopathology, and the ability of ultrasound in differentiating between a benign or malignant lesion was determined. Results: The ultrasound features favoring a malignant lesion included – solid consistency (Sn 92.3%; Sp48.6%; p=.009), hypoechoic echo-pattern (Sn 100%; Sp 54.5%: p=.004), micro-calcification (Sn 69.3%; Sp97.3%; p=.000), taller than wider shape (Sn 53.8%; Sp 89.1%; p=.001), ill-defined margins (Sn 61.5%;Sp 91.9%; p=.000) and internal vascularity (Sn 84.6%; Sp67.5%;p=.001). The ultrasound diagnosis was in agreement with the final diagnosis in 90% of the cases.The overall sensitivity, specificity and PPV of ultrasound in identifying a malignant lesion was 92.31%, 97.30%, and 92.31% respectively. Conclusion: Ultrasound is an excellent non-invasive modality to evaluate thyroid nodules. It is a highly sensitive imaging modality for identifying and characterizing a lesion as benign or malignant.
Highlights
Thyroid diseases are one of the commonest endocrine disorders worldwide and about 42 million people in India suffer from thyroid diseases.[1]
A number of ultrasound features have been identified over the last 15-20 years which assist in predicting the risk of malignancy in a thyroid lesion
The overall sensitivity reported for any one suspicious ultrasound feature is 83 – 93%.[15,11,16]
Summary
Thyroid diseases are one of the commonest endocrine disorders worldwide and about 42 million people in India suffer from thyroid diseases.[1]. The major limitation of ultrasound in thyroid imaging is that it cannot determine thyroid function, i.e., whether the thyroid gland is underactive, overactive or normal in function.[7] there is some overlap between the ultrasound appearance of benign and malignant nodules, certain US features are helpful in differentiating the two. The halo or hypoechoic rim around a thyroid nodule is produced by a pseudo-capsule of fibrous connective tissue, Lymph node Metastases compressed thyroid parenchyma, and chronic inflammatory. A halo is absent at the US in more bulging shape, increased size, replaced fatty hilum, irregular than half of all benign thyroid nodules.[9] The absence of a margins, heterogeneous echo-texture, calcifications, cystic halo has a specificity of 77% and a sensitivity of 67% in areas, and vascularity throughout the lymph node instead of predicting malignancy.[8]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call