The diagnostic value of doppler ultrasonography in determining the malignancy potential of thyroid nodules
F Sahin, M Varer, A Sarsilmaz, G Oruk, M Apaydin & E Uluc
Objective: It is very important to determine the malignancy risk in thyroid nodules for to improve therapeutic strategies. In this study we attempted to evaluate the relationship of doppler (DUS) and B- mode ultrasonographic (BUS) features of thyroid nodules with fine needle aspiration (FNA) findings.
Method: 111 patients which have been followed between March and September 2004 were evaluated with ultrasonography and ultrasound guided FNA was performed in 124 nodules. The size, number and echogenicity of the thyroid nodules were studied with BUS. The vascularity of the thyroid nodules was assessed by (DUS). Flow characteristics was classified between Type 1 and 4, peak systolic velocity, resistive index values were calculated and were correlated with cytopatological findings.
Results: 88 of the patients were female (%80), 23 of the patients were male (%20). In evaluation of 124 nodules with FNA, 110 nodules were diagnosed as benign (90.7%), 10 nodules as malignant (8.5%), 4 nodules (0.35%) as indeterminate. The results of the BUS yielded: In 68% of the patients with benign nodules and 100% of the patients with malignant nodules had more than one nodule. 64% of benign nodules and 20% of malignant nodules were less than 2 cm. When these nodules were evaluated with DUS type-4 blood flow (80%) in malignant nodules and type-2 blood flow (52.7%) in benign nodules were observed. Peak systolic velocity values under 50 cm/sec were diagnostic for benign nodules, whereas values over 50 cm/sec were diagnostic for malignant nodules. Resistive index (RI) values were <0.75 in 93.5% of benign nodules and >0.75 in 60% of malignant nodules.
Conclusion: The nodules which are over 2 cm in size have more malignant potential. Also nodules which have increased intranodular blood flow, peak systolic value over 50 cm/sec, RI values over 0.75 carries high risk for malignancy.