Author(s): Battula Venkateswarlu
AIMS & OBJECTIVES:
1. To differentiate cystic lesions from solid lesions.
2. The possibility to differentiate the intrinsic thyroid lesions from those arising from adjoining structures.
3. To evaluate the neoplasms and to differentiate benign from malignant lesions by USG characteristics and to correlate with FNAC reports.
4. Role of USG in rapidly growing thyroid lesions: To differentiate haemorrhage into the cystic lesions and rapidly growing malignant tumours.
5. Compare the results of our study with similar studies available in the present literature.
MATERIALS & METHODS
This study included 75 patients who attended outpatient departments of the Endocrinology, Medical and Surgical Units and also those who were inpatients.
Broadly pathological conditions of thyroid glands can be divided into nodular and diffuse thyroid diseases.
Among Nodular Diseases
Majority are benign, only few are malignant.
Characteristics of benign lesions are:
1. Well-differentiated margins.
2. Thin complete peripheral sonolucent halo.
3. Coarse peripheral calcifications.
Characteristics of malignant nodules are:
1. Ill-defined margins.
2. Thick incomplete peripheral halo.
3. Fine punctuate calcifications.
Diffuse Thyroid Diseases
1. Hashimoto’s thyroiditis: Painless diffuse enlargement of thyroid gland usually in women with coarse echotexture and no normal gland tissue. There may be discrete hypoechoic nodules within it with cervical lymphadenopathy.
2. Goitres: a) Simple diffuse goitre: Symmetrical enlargement of gland without tenderness or bruit or lymphadenopathy, T3, T4 and TSH are within normal limits and no thyroid autoantibodies in the serum.
a) Diffuse Toxic goitre: Diffuse enlargement of gland with increased vascularity on colour Doppler study.
b) Multinodular goitre: Multiple hypoechoic nodule within normal thyroid parenchyma.
c) Colloid goitre: Present as single or multiple swellings in the thyroid gland.
USG is the fast and cost effective modality of imaging investigations of choice in thyroid diseases. It helps to know:
1. Whether patient has focal or diffuse abnormality.
2. Whether lesions are solitary or multiple.
3. Whether they are cystic or solid.
4. Whether the lesion is benign or malignant can be differentiated by sonographic characteristics.
5. Further Hashimoto’s thyroiditis or toxic goitre can be successfully differentiated by USG and colour Doppler findings.
6. US guided FNAC is the confirmatory tool.