Publication:

Diagnostic accuracy of ultrasonography in goiters: a tertiary centre experience

Background Thyroid diseases are highly prevalent in India, especially in the southern states. Evaluation of thyroid pathologies revolves mainly on imaging and cytology. Recent advances in thyroid imaging have greatly improved the diagnosis, treatment and follow-up in thyroid diseases. Though there are advanced modalities including Computed Tomography and Magnetic Resonance Imaging, Ultrasonography remains the cornerstone for the evaluation of thyroid gland, due to its ubiquitous availability and cost-effectiveness. The objectives of the study were to find out the diagnostic accuracy of ultrasonography in thyroid swellings and to find out the most reliable diagnostic feature of thyroid malignancy in ultrasonography.

Methods This was an observational study, conducted on 71 patients admitted to the General surgical wards of Government Medical College, Trivandrum, with thyroid swellings, for a period of 18 months. For all these patients, ultrasound scan of the thyroid gland was done on an ultrasound machine with a 17/5 MHz linear transducer, by experienced faculty.

Results Ultrasonography was found to have a sensitivity of 87.2% and a specificity of 79.2% in diagnosing thyroid pathologies. The most common malignancy of thyroid found in the study was papillary carcinoma and the most reliable ultrasound finding suggestive of malignancy was microcalcification.

Conclusions As per the present study, it is concluded that high resolution ultrasonography is very useful in diagnosing the nature of thyroid swellings, with an accuracy rate of 84.5%. Ultrasonography is a valuable diagnostic tool in the evaluation of thyroid diseases and is the imaging modality of choice.