The diagnostic value of ultrasonography in detection of different types of thyroid nodules
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The Egyptian Journal of Otolaryngology
(2020) 36:23
ORIGINAL ARTICLE
Open Access
The diagnostic value of ultrasonography in detection of different types of thyroid nodules Ahmed Youssef1,2* , Mohamed Hesham Abd-Elmonem1, Rania Ahmed Mohamed Ghazy1, Mohamed Mahmoud El Shafei3 and Mohamed Zahran1
Abstract Background: This article discusses the importance of high frequency ultrasonography in detection of different types of thyroid nodules considering only the histopathological examination of the surgical specimens as the final diagnosis. We studied 50 patients referred to ENT clinic with a thyroid nodule. Ultrasonography and ultrasound-guided fine-needle aspiration biopsy were done to all the patients. Thyroid surgery was done according to FNAB results. Result: From 50 thyroid specimens, the US could predict the malignancy in 18 specimens. By histopathology, only 16 specimens were malignant, and 34 were benign thyroid disease. The sensitivity, specificity, and accuracy of US were 100%, 94.12%, and 96% respectively. The most suspicious ultrasongraphic feature was microcalcification followed by taller than wider (T ˃ W). Conclusion: High frequency ultrasound is a very important tool to predict the malignant possibility during thyroid nodule evaluation. Keywords: Ultrasound (US), Fine-needle aspiration biopsy (FNAB), Thyroid nodule, Microcalcification
Background The thyroid nodule (TN) is a discrete lesion that could be distinct radiologically and pathologically from the normal thyroid parenchyma [1]. It is considered the most common abnormality in the endocrine system. Using ultrasonography (US) in thyroid nodule detection has raised the nodule prevalence to reach 67%. Seven to fifteen percent of thyroid nodules are malignant [2, 3]. The current goal in the TN evaluation is to determine whether it is benign or malignant [4]. Usually, the US is the first choice among the imaging studies during TN assessment followed by ultrasound-guided fine-needle aspiration biopsy (FNAB), and mostly the surgery * Correspondence: [email protected]; [email protected] 1 Department of Otorhinolaryngology—Head and Neck Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt 2 Department of Otolaryngology—Head and Neck Surgery, John Hunter Hospital, Newcatle, NSW, Australia Full list of author information is available at the end of the article
decision or leaving the nodule alone is dependent on the FNAB result. However, FNAB has several limitations including inadequate sampling, operator dependency, and false negative cytology rates (10–30%) [5–8]. Recently, several studies have been performed using high frequency ultrasonography to determine suspicious features of malignant TN like taller than wider in shape, microcalcifications, solid texture, central vascularity, hypoechogenicity, and irregular margin [4, 9–11]. The purpose of this study is to determine the diagnostic value of US in the evaluation of TN in comparison with the final histopathological examination of thyroid surgical specimen.
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