STRAIN USG ELASTOGRAPHY WITH GRAY SCALE AND COLOUR DOPPLER IMAGING OF THYROID NODULES - EFFICACY COMPARED WITH FNAC

A.KARPAGAVALLI; Dr.E.MANIMEKALA; Dr.R.Ravi; DR.N.KAILASANATHAN

Volume : IX, Issue : III, March - 2019

STRAIN USG ELASTOGRAPHY WITH GRAY SCALE AND COLOUR DOPPLER IMAGING OF THYROID NODULES - EFFICACY COMPARED WITH FNAC

A. Karpagavalli, Dr. E. Manimekala, Dr. R. Ravi, Dr. N. Kailasanathan

Abstract :

Context: Thyroid nodules are very commonly observed on Thyroid USG. Although conventional USG can provide meaningful information in thyroid nodule diagnosis, there has been considerable variation in diagnostic performance. As a consequence, a significant number of patients eventually receive unnecessary invasive thyroid procedures. Therefore, improvement and refinement of noninvasive methods to depict malignancy are needed. In this context, US Elastography (USE) has recently been introduced in the clinical workup of thyroid nodules. Aim: The purpose of the study is to compare sonography combined with USE findings of thyroid lesion with the cytological results of fine needle aspiration cytology ( FNAC ) and determine the accuracy of ultrasound combined USE findings in diagnosis of thyroid lesions. Methods and Material: This prospective study was carried in Rajiv Gandhi Government General Hospital for a period of 1 year. Patients were screened as per inclusion and exclusion criteria. A total of 100 patients with thyroid nodules underwent High frequency sonographic examinations and free hand elastography using Hitachi Aloka Arietta S70 Machine. Elastographic images were used and modified Asteria scale were assigned for each focal thyroid lesion. These were then correlated with histopathological results. The ability of these various imaging modalities along with HPE to differentiate between benign and malignant focal thyroid lesions was assessed. Statistical analysis used: The collected data were analysed with IBM.SPSS statistics software 23.0 Version. Results: The sensitivity of grayscale USG in detecting malignant thyroid nodules was 100% but specificity was 91.8% . Some lesions were overlooked compared with FNAC. US Elastography showed sensitivity of 100% but specificity was 89.7 % . Here also some lesions were overlooked compared with FNAC. Accuracy of gray–scale US features was mostly higher than that of elastography, but it was not statistically significant . 96 benign nodules and 4 probably malignant nodules were detected by using both techniques. Combining USG gray scale and Elastography showed sensitivity of 100% but specificity was 99% .Overall accuracy was 99.5%. Conclusion: 96 benign nodules and 4 probably malignant nodules were detected by using both techniques. Combining USG gray scale and Elastography showed sensitivity of 100% but specificity was 99% .Overall accuracy was 99.5%.