Dr. Hesham Mohamed Farouk Ibrahim :: Publications:

Value of color Doppler sonography alone or in combination with gray scale one in diagnosis of malignant cold solitary solid thyroid nodule. Hesham M. Farouk ,MD. Osama Taha Galal, MD, Ahmed El-shal, MD* Sobhy AbouEl-fotouh, MD* Yasser H Mohamed* and Tawfik El-Adl, MD. Diagnostic radiology, ENT * and internal medicine department- Benha faculty of medicine, Benha university. Abstract:- The purpose of this study was to provide color flow criteria alone or in combination with Gray scale sonography criteria for differentiation between benign and malignant cold solitary solid thyroid nodule. Twenty six patients with cold solitary solid thyroid nodule were selected from 93 patients with thyroid swelling after clinical examination, laboratory and radiological investigations. Sonography finding that suggested malignancy included micro-calcification, an irregular or microlobulated margin, marked hypo-echogenicity, a shape that more tall than it was wide and type III color flow pattern were recorded. If even one of these sonography features was present the nodule was classified as positive (malignant) and if a nodule had none of the features described, it was classified as negative (benign). Hemi-thyroidectomy was done for all the cases with solitary nodule. The final diagnosis of a feature as benign or malignant was confirmed by histopathological examination to excised specimens. The sensitivity, specificity and accuracy were then calculated on the basis of our proposed classification method. Of 17 histopathologically benign cases, 6 were classified as positive. The accuracy of color Flow Doppler (CFD) alone was 65.4% while in combination with gray scale parameters the mean accuracy was 74.3%. Conclusion: No single US criterion is reliable in differentiating benign from malignant nodule. The color Doppler alone cannot reliably distinguish benign from malignant thyroid nodule and also when added to gray scale parameters did not increase the accuracy. We recommended more study to this technique before any final conclusion can be drawn as to its accuracy in diagnosis of thyroid carcinoma.