ABSTRACT

Aim: To examine the diagnostic accuracy of ultrasound for diagnosing malignant thyroid nodules and its management taking fine needle aspiration cytology as a gold standard.

Study Design: Cross-sectional study

Place and Duration of Study: Department of Diagnostic Radiology and ENT and Head & Neck Surgery Civil Hospital Quetta and Yaseen Hospital Quetta from 1^st March 2017 to 31^st December 2019

Methods: One hundred and twenty patients of both genders with ages 20 to 65 years clinically diagnosed to have thyroid nodules were included in this study. Patient’s detailed demographics were recorded after taking informed written consent. Ultrasound imaging was performed to all the patients and compared the findings with ultrasound guided. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of ultrasound were examined. Total thyroidectomy was performed and follow-up was taken at 1 year post-operatively to examine the recurrence rate.

Results: Ninety (75%) were females while 30 (25%) were males with mean age 39.14±12.85 years. 29 (24.17%) patients had malignant and 91 (75.83%) had benign thyroid nodules by ultrasound while on FNAC 30 (25%) patients had malignant and 92 (76.67%) had benign nodules. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of ultrasound compare to FNAC were 86.67%, 96.67%, 89.66%, 95.60% and 94.17% respectively. Total thyroidectomy was performed to all the patients who had positive findings of malignancy. Out of 30 patients 25 (83.33%) were females while 5 (16.67%) were males with mean age 40.25±13.57 years. At 1 year follow-up none of patients had recurrence.

Conclusion: Ultrasound plays an important role for diagnosing malignant thyroid nodules with high diagnostic accuracy rate. It is very helpful tool for making decision for the management of thyroid nodules.

Keywords: Thyroid Nodules, Ultrasound, Fine needle aspiration cytology, Thyroidectomy