Role of Ultrasound in Thyroid Pathologies

ABSTRACT

Disorders of thyroid gland may result from developmental failures, abnormalities of hormone production and structural changes which may or may not be accompanied by changes in function. The normal thyroid gland consists of two lobes and a bridging isthmus. Thyroid size, shape and volume vary with age and sex. Ultrasound is the initial and the commonest modality to study the thyroid gland. The thyroid gland is slightly more echo-dense than the adjacent structures because of its high iodine content. It has a homogenous ground glass appearance that makes detection of focal cystic or hypoechoic thyroid lesions relatively easy. The aim of the present study was to assess the nature of pathologies of thyroid gland, differentiate between focal and diffuse pathology and perform a Sonographic interpretation with subsequent confirmation by FNAC. The present prospective observational study was carried out in the Department of Radio-Diagnosis, Government Medical College and Associated Hospitals Srinagar. A convenience sampling of all patients referred to the Department of Radio-Diagnosis from OPD, in-patient wards or Emergency wing for thyroid ultrasound scan were included in study. Detailed history was elicited; Study was done on Logic S8 Ultrasound using 12 MHz linear array transducer. Before the ultrasound guided FNAC, the neck was hyperextended and skin was cleaned with povidine – iodine (Betadine) solution. The male female ratio was 12.3. Maximum number of patients, 42(84%) came with clinically thyroid enlargement followed by pain in 7 cases (14%), 6(12%) cases presented with pressure effects like dysphagia, dyspnoea and hoarseness of voice. 3(6%) cases presented with signs of hyperthyroidism like tremors, sweating and loss of weight. Lesser involvement was seen in Left Lobe (8%). Total number of cases with swellings (84%) was more than cases (16%) with no swellings. In the study, majority of lesions had hypoechoic echotexture (34%) followed by isoechoic (28%) and heterogenous (24%). In this study among malignant cases papillary carcinoma was most common lesion in 83.34% of cases followed by anaplastic carcinoma in 1(16.66%) case.