Dergiler / Ankara Üniversitesi Tıp Fakültesi Mecmuası / 2016 / Cilt: 69 - Sayı: 2
Tiroid Nodüllerinde Ultrasonografi ve Renkli Doppler Ultrasonografi Bulguları Birlikteliğinde Malignite Saptanması
- Sayfa
- 111–116
- DOI
- —
Özet
Objective: To determine parameters that can be used to predict malignant thyroid nodules by using grayscale ultrasonography and color Doppler ultrasonography Materials-methods: Gray-scale ultrasonography and color Doppler ultrasonography findings were retrospectively analyzed in 60 nodules with known histopathology. Of 60 nodules, 12 nodules were malignant. The evaluation criteria for gray-scale ultrasonography were: size, echotexture, internal morphology, contour, presence of microcalcification, and presence of halo sign. The evaluation criteria for color Doppler ultrasonography were: vascular flow pattern and resistive index. Vascular flow patterns were classified as Types I, II, III, and IV. Results: Irregular contour and type IV flow patterns were the most significant independent predictors of malignancy in malignant thyroid nodules. Resistive index was significantly higher in malignant nodules. The cut off value was established as resistive index 0.69; 91% sensitivity and 97% specificity were calculated in the identification of malignant nodules. A combination of the absence of a halo sign, type IV flow pattern, and irregular contour had the highest specificity and positive predictive value (66.7% sensitivity, 100% specificity, 100% positive predictive value, 92.3% negative predictive value). Conclusion: We believe that by the integration gray-scale ultrasonography with color Doppler ultrasonography findings, it is possible to determine which nodule is malign/benign without performing fine needle aspiration biopsy (FNAB) and unnecessary operations could be prevented.
Abstract
Objective: To determine parameters that can be used to predict malignant thyroid nodules by using grayscale ultrasonography and color Doppler ultrasonography Materials-methods: Gray-scale ultrasonography and color Doppler ultrasonography findings were retrospectively analyzed in 60 nodules with known histopathology. Of 60 nodules, 12 nodules were malignant. The evaluation criteria for gray-scale ultrasonography were: size, echotexture, internal morphology, contour, presence of microcalcification, and presence of halo sign. The evaluation criteria for color Doppler ultrasonography were: vascular flow pattern and resistive index. Vascular flow patterns were classified as Types I, II, III, and IV. Results: Irregular contour and type IV flow patterns were the most significant independent predictors of malignancy in malignant thyroid nodules. Resistive index was significantly higher in malignant nodules. The cut off value was established as resistive index 0.69; 91% sensitivity and 97% specificity were calculated in the identification of malignant nodules. A combination of the absence of a halo sign, type IV flow pattern, and irregular contour had the highest specificity and positive predictive value (66.7% sensitivity, 100% specificity, 100% positive predictive value, 92.3% negative predictive value). Conclusion: We believe that by the integration gray-scale ultrasonography with color Doppler ultrasonography findings, it is possible to determine which nodule is malign/benign without performing fine needle aspiration biopsy (FNAB) and unnecessary operations could be prevented.