Publication:

Evaluation of color Doppler study of thyroid swellings: a prospective study at JSS hospital, India

Background Color Doppler sonography of thyroid is an emerging and promising pre-operative investigatory modality for thyroid diseases at present. Because of superficial location and good vascularisation of thyroid gland high resolution real time grey scale and color Doppler sonography can delineate and demonstrate the normal thyroid anatomy and pathological conditions with remarkable clarity.

Methods Present study includes total number of 50 cases admitted in JSS Hospital, Mysore, India from September 2014 to September 2016. Color assisted duplex sonography was performed following a detailed history and physical examination. All routine investigations and specific investigations like thyroid function tests and FNAC were done. Later on patients were subjected to thyroid surgery as required, based on the diagnosis. The histopathological findings obtained for the resected thyroid specimens were compared with the previously scan findings.

Results Thyroid ultrasound was efficient in picking up all 50 cases in our study. The most common benign lesion determined in our study were adenomatous nodules which was the most common benign lesion, we were able to detect malignant nodules with a better specificity. According to several reports, for the differentiation of benign versus malignant thyroid nodules, sonography has sensitivity rates ranging from 63% to 94%, specificity from 61% to 95% and an overall accuracy from 80% to 94%. In our study we found sensitivity of 55.56%, specificity of 90.24%, positive predictive value of 55.56%, and negative predictive value of 90.24% and overall diagnostic efficiency of 84%.

Conclusions Ultrasound is valuable for identifying many malignant or potentially malignant thyroid nodules. Although there is some overlap between the ultrasound appearance of benign nodules and that of malignant nodules, certain features are helpful in differentiating between the two. The newly developed high resolution ultrasonography with color Doppler flow mapping function can reveal fine details of the thyroid gland and the haemodynamic features of thyroid neoplasms.