مقایسه اولتراسونوگرافی با سیتولوژی وپاتولوژی در ندول های تیروئید

Background and purpose: The gold standards for diagnosis of thyroid nodules are cytology (FNA) and pathology. However, the role of ultrasonography is rising in detection and characterization of malignant and benign thyroid nodules. This study compared these two diagnostic methods to establish a complementary role for ultrasonography. Materials and methods: This cross-sectional study was performed between June 2008 to October 2009. Two hundred and fifty four patients with thyroid gland nodule or nodules were evaluated by US, CFD and FNA in Sari Imam Khomeini Hospital. The collaboration between radiologist and pathologist/endocrinologist was double blind. After data acquisition we used SPSS-17 to calculate the sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) for all 12 variables. We also determined cutoff point for thyroid nodule size by drawing Roc curve and measuring the cutoff point. The data was then analyzed using regression logistic analysis. Results: Frothy-four patients with inadequate cytology were excluded from the study. In the remaining 210 patients we found 191(91%) benign, 12(5.7%) suspicious and 7(3.3%) malignant nodules in cytology. All patients with malignant cytology and eight patients from twelve patients with suspicious cytology underwent surgery. After surgery and pathological study 11(5.34%) were found malignant. Malignant lesion showed higher frequency of enlarged thyroid lobe with prominent nodule (63.6 vs. 20.5% P<0.01) and blurred margin nodules than benign nodules (54 vs. 5.1% p<0.0001) Conclusion: Our study demonstrated that no single parameter could identify malignancy. We found that blurred margin and enlarged thyroid lobe with prominent nodule is the best differentiating factor between missing malignancy and benignicity.