Benign ve Malign Tiroid Nodüllerinin Ayırımında Renkli Doppler Ultrasonografinin Rolü

ÖZET Amaç: Tiroidin nodüler hastalığı sık karşılaşılan endokrin hastalıklardandır. Tüm tiroid nodüllerinin %5-15inde tiroid karsinomu olasılığı vardır. Günümüzde tiroid nodüllerinde temel tanısal yöntem tiroid ince iğne aspirasyon biopsisidir (İİAB). Çalısmamızda, tiroid nodülü olan olgularda renkli Doppler US (RDUS) özelliklerinin degerlendirilmesi ve benign ve malign tiroid nodüllerinin ayırımında RDUSun rolünün saptanması amaçlandı. Gereç ve Yöntem: Çalışmaya 129 olgu dahil edildi. Nodüller histopatolojik ve sitolojik sonuçlarına göre benign ve malign nodüller olmak üzere gruplara ayrıldı. Nodüllerin lokalizasyon, boyut ve iç yapısı araştırıldı. RDUS ile kanlanma tipi, kan akım hızının en yüksek değeri (Vmax ), kan akım hızının en düşük değeri (Vmin), kan akımının sistolik tepe değerinin diastol sonu değeri (S/D)'ne oranı, pulsalite indeksi (PI), rezistif indeks (RI), akselerasyon zamanı (AT) ve akselerasyon indeks (AI) değerlerine bakıldı. Bulgular: Benign ve malign nodüllerin ayrımında vaskülarizasyon tipleri istatistiksel olarak anlamlıydı. Ayrıca RDUS bulgularına göre benign ve malign nodül içindeki S/D oranı, PI, RI ve AI değerleri de istatistiksel olarak anlamlıydı. Sonuç: US ve RDUSun beraber kullanımı benign ve malign tiroid nodüllerinin ayrımında tanıya katkı sağlayabilir. Bu sayede gereksiz İİAB lerde azaltılabilir.

The Role of Color Doppler Ultrasound Differantiation of Malignant and Benign Thyroid Nodules

Objective: Nodular disease of the thyroid is a common endocrinologic disorder. Five to fifteen percentage of all thyroid nodules are thought to be malignant. Current diagnostic modality of choice for characterization of thyroid nodules is fine needle aspiration biopsy (FNAB). We aimed to this study was to evaluate the color Doppler ultrasonography (CDUS) findings of patients with thyroid nodules and also to detect the role of CDUS differantiation between malignant and benign thyroid nodules. Material and Method: One hundred and twenty nine nodules were included this study. These nodules were divided into benign and malignant nodules, according to their histopathologic and cytologic results. Localization of nodules, size and internal structure were investigated. CDUS were used to evaluate the type of vascularization, Peak systolic Velocity, peak diastolic velocity, systole/diastole (S/D) ratio, pulsatility index (PI), resistive index (RI), acceleration index (AI) and acceleration time (AT) of the nodules. Results: Vascularization type were statistically significant different between benign and malignant nodules. There were also statistically significant differences between benign and malignant nodules at the S/D ratio, PI, RI, AI. Conclusion: We think using together with US and RDUS may be contribution for the diagnosis and differentiating between nodules of benign and malign. It also prevented unnecessary FNAB.

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