Evaluation of thyroid nodules in patients with goitre using nuclear medicine, biopsy and ultrasound in Sudan

ABSTRACT

Goiter is a common thyroid disorder in Sudan. Most of thyroid nodules are benign, but a small percentage can be cancerous among the other pathology. The aims of this study were to assess the value of scintigraphy, ultrasound [US] and biopsy in the detection of nodules and to determine the prevalence of thyroid nodule among patients with thyroid goiter in Sudan. A total of 100 patients were investigated. 58 patients were investigated with biobsy in addition to the aforementioned techniques. Scintigraphic examination involved the intravenous injection of 2-5 mCi of Tc[99m] followed in 15 minutes by 300 kC at the neck, US was performed using an instruments with a 7.5 MHz and biopsy was carried either by Fine Needle Aspiration Biopsy [FNAB] or open operation. The majority of the patients were females [81%]. Scintigraphy revealed that 58% of the patients had nodular goiter while the rest had diffuse goiter. The highest incidence of nodules was shown in the age group between 40-60 [23%]. US revealed that 48% of the nodules were solitary. Furthermore, 78% the nodules none vascularized, 29% were calcified and 28% were hypoechoic. The biopsy results showed that 14% of nodular patients were malignant, 88% follicular adenocarcinoma. 36% had nodular goiter with cystic or degenerative changes. The highest percentage of malignancy could be attributed to the fact that patients referred to the hospital in a late stage of the disease. All patients with giotre should undergo US and NM investigation in order to detect the morphology and function of the thyroid