Role of gray-scale ultrasound, Doppler, and ultrasound elastography in the evaluation of nodular goiter

Background Thyroid nodules are very common. Most nodules are benign, with less than 5% of them being malignant. High-resolution ultrasound (US) is sensitive in detection of thyroid nodules, enabling differentiation of solid and cystic lesions. Conventional US does not provide information regarding hardness of the nodule and this is often the role of Ultra Sound Elastography (USE). US elastography was developed to work out tissue stiffness and strain information noninvasively. Aim The aim was to judge of the accuracy of gray-scale US, Doppler, and US elastography in the diagnosing of nodular thyroid diseases. Patients and methods The study included 20 consecutive patients with a clinically diagnosed multinodular goiter presented to Otorhinolaryngology OutPatient Clinic. All patients have been subjected to detailed history taking, complete Oto Rhino Laryngology (ORL) head and neck examination, complete general examination, and routine investigations for general anesthesia. Radiological imaging using conventional US and real- time US, Doppler study of the whole thyroid gland by the same probe, and elastography. Suspicious nodules were subject to Fine Needle Aspiration Cytology (FNAC) and surgery was done by ORL surgeon in the ENT department. Results In this study, 20 cases were included from which 19 cases were benign and only one case was malignant. There was a high statistical significance in-between the US classification and elasticity score with P less than 0.001, and high statistical significance in-between Doppler signs and elasticity score with P less than 0.001. Conclusion US elastography may be a promising technique that combined with other US modalities is straightforward and rapid to perform and might help to spot thyroid nodules that are likely to be malignant.