Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Role of Duplex Power Doppler Ultrasound in Differentiation between Malignant and Benign Thyroid Nodules

  • Algin, Oktay (Department of Radiology, Ataturk Training and Research Hospital Bilkent) ;
  • Algin, Efnan (Department of Oncology, Gazi University Medical Faculty) ;
  • Gokalp, Gokhan (Department of Radiology, Uludag University Medical Faculty) ;
  • Ocakoglu, Gokhan (Department of Biostatistics, Uludag University Medical Faculty) ;
  • Erdogan, Cuneyt (Department of Radiology, Uludag University Medical Faculty) ;
  • Saraydaroglu, Ozlem (Department of Pathology, Uludag University Medical Faculty) ;
  • Tuncel, Ercan (Department of Endocrinology, Uludag University Medical Faculty)
  • Received : 2010.04.20
  • Accepted : 2010.07.26
  • Published : 2010.12.01
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Abstract

Objective: To evaluate the usage of duplex power Doppler ultrasound (PDUS) for the differentiation of benign and malignant thyroid nodules. Materials and Methods: We prospectively examined 77 thyroid nodules in 60 patients undergoing ultrasound-guided fine needle aspiration biopsy (FNAB). Each nodule was described according to size, inner structure, borders, parenchymal echogenicity, peripheral halo formation, and the presence of calcification (B-mode ultrasound findings). Vascularity as determined by PDUS imaging was defined as non-vascular, peripheral, central, or of mixed type. For each nodule, the pulsatility index (PI) and resistive index (RI) values were obtained. Results of FNAB and surgical pathological examination (if available) were used as a proof of final diagnosis to categorize all nodules as benign or malignant. A receiver operating characteristic (ROC) curve analysis was performed to establish cut-off, sensitivity, and specificity values associated with RI-PI values. Results: A significant relationship was observed between malignancy and irregular margins, microcalcifications, and hypoechogenicity on ultrasound examination (p < 0.05). The pattern of vascularity as determined by PDUS analysis was not a statistically significant criterion to suggest benign or malignant disease in this study (p > 0.05). The central, peripheral, and mean RI-PI values were higher in malignant nodules when compared to the other cytologies (p < 0.05). Conclusion: Vascularity is not a useful parameter for distinguishing malignant from benign thyroid nodules. However, RI and PI values are useful in distinguishing malignant from benign thyroid nodules.

Keywords

References

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