DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20192724

Comparative study of colour Doppler vs. FNNAC findings in WHO grade II thyroid enlargement in adult females

Sudhakar Rao M. S., Navneeth T. P., John C. J.

Abstract


Background: Thyroid gland disorders form one of the most common endocrinal and surgical problems encountered in clinical practice. FNNAC is widely accepted as the primary and better method than FNAC for investigation but has its disadvantages. Colour Doppler is a non-invasive, low cost, easily available and repeatable investigation with least patient discomfort and can be valuable in detection of benign and malignant thyroid enlargements.

Methods: Forty cases of adult females with WHO grade 2 thyroid enlargement attending the department of otorhinolaryngology selected on simple random basis were included in this study. Following written consent, Colour Doppler scanning and FNNAC test were done on the thyroid swelling and the results were analysed.  

Results: The mean age of patients was 32.44 years. The mean age of malignancy was 44.66 years and showed statistically significant association. The Resistive and Pulsatility index and combination of both were found to have statistically significant results in detecting malignant and benign lesions The sensitivity, specificity, positive and negative predictive values of RI and PI were 83.33%, 94.12%, 71.43%, 96.97% and 50%, 94.12%, 60% and 91.43% respectively. On combining both the indices, the sensitivity was 91.67% and the positive predictive value was 97.06%.

Conclusions: Colour Doppler can differentiate between benign and malignant thyroid enlargements using Resistive index (of>0.75) and Pulsatility Index (of>1.5) and can be a complementary diagnostic tool in the thyroid enlargement lesions, considering its accuracy, cost-effectiveness, easy availability and non-invasive repeatable nature.


Keywords


FNNAC, Colour Doppler, Resistive index, Pulsatility index

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References


Wiest PW, Hartshorne MF , Inskip PD, Linda A, Crooks. Thyroid palpation verus high- resolution thyroid ultrasonography in the detection of nodules. J Ultrasound Med. 1998;17:487-96.

Morstensen JD, Woolner LB, Bennett WA. Gross and microscopic findings in clinically normal thyroid glands. J Clin Endocrinal Metab. 1955;15:1270-80.

Carroll BA. Asymptomatic thyroid nodules: incidental sonographic detection. Am J Roentgenol. 1982;138(3):499-501.

Woestyn J, Afschrift M, Schelstraete K, Vermeulen A. Demonstration of nodules in the normal thyroid by echography. Br J Radiol. 1985;58(696):1179-82.

Brander AE, Viikinkoski VP, Nickels JI, Kivisaari LM. Importance of thyroid abnormalities detected at US screening: a 5-year follow-up. Radiology. 2000;215(3):801-6.

Mazzaferri EL. Management of a solitary thyroid nodule. New England J Med 1993;328(8):553-9.

WHO|Data sources and inclusion criteria for the Database on Iodine Deficiency. Avaliable at https://www.who.int/vmnis/database/iodine/iodine_data_sources/en/

Prasad CV. Evaluation of correlation between ultrasonography and FNAC of thyroid nodules. IAIM. 2016;3(2):92-7.

De Nicola H, Szejnfeld J, Logullo AF, Wolosker AM, Souza LR, Chiferi V Jr. Flow pattern and vascular resistive index as predictors of malignancy risk in thyroid follicular neoplasms. Journal of ultrasound in medicine. Official J Am Institute Ultrasound Med. 2005;24(7):897-904.

Maurya A, Mehta A, Mani N, Nijhawan V, Batra R. Comparison of aspiration vs non-aspiration techniques in fine-needle cytology of thyroid lesions. J Cytol. 2010;27(2):51.

Butt MGM, Nafees M, Aquil H. Diagnostic accuracy of color flow doppler in thyroid tumors. Pak Armed Forces Med J. 2017;67(2):216-21.

Chaudhary S, Verma AP, Mishra HK. High resolution ultra sound and color doppler in evaluation of thyroid nodule with fine needle aspiration cytology correlation. Int J Res Med Sci. 201;4(9):4113-8.

Kapur MM, Sarin R, Karmakar MG, Sarda AK. Solitary thyroid nodule. Indian J Surg. 1982;44:174-9.

Aggarwal A, Kaur N, Bhardwaj, Grover AS. Color Doppler evaluation of thyroid nodules: validation of quantitative & qualitative analysis in predicting malignancy. Intern J Adv Res. 2015;(3)7:1120-6.

Chammas MC, Gerhard R, de Oliveira IR, Widman A, de Barros N, Durazzo M et al . Thyroid nodules: evaluation with power doppler and duplex doppler ultrasound. Otolaryngol Head Neck Surg. 2005;132(6):874-82.

Holden A. The role of colour and duplex doppler ultrasound in the assessment of thyroid nodules. Australas Radiol. 1995;39:343–9.

Cerbone G, Spiezia S, Colao A. Power doppler improves the diagnostic accuracy of color doppler ultrasonography in cold thyroid nodules: follow-up results. Horm Res. 1999;52:19–24.