Toor R, Shah S H, Hameed A, Amin M, Zareen S, Iqbal B, Maqbool M, Iqbal M, Bashir M, Nasir Z.
Cold nodule on thyroid scan – usefulness of ultrasound in prediction of malignant behavior.
J Surg Pak Jan ;12(1):8-12.

Objective: To determine the usefulness of sonographic features in predicting the risk of malignancy in cases of a solitary cold nodule on Tc-99m thyroid scan. Design: It is an observational cohort study. Place and duration of study: The study was conducted at Atomic Energy Medical Centre and Surgical Unit 2, Jinnah Post Graduate Medical Centre from January 2005 –December 2006. Patients and Methods: Two hundred fifty patients were randomly selected with the suspicion of solitary thyroid nodule on physical examination. Of these only 103 patients had cold nodule on Tc-99m thyroid scan and underwent thyroid sonography, FNAC and elective surgery. Results: Out of 03 selected patients 70 (68%) were females, with the ratio of 1:3, within the age group of 17-60 years. Of these 16 (15%) patients were confirmed as well differentiated carcinoma thyroid, while 7 (7.2%) patients had colloid or hemorrhagic cysts, 23 (23.6%) follicular adenoma, 40 (41.2%) had multi-nodular goiter, 13 (13%) had nodular goiter, 03 (3%) had colloid goiter and 01 (1 %) had nodular adenomatous hyperplasia. Sonographic features of thyroid nodule were quantified by scoring according to the echo texture, internal architecture, margins, calcification and vascularity. Conclusion: Sonographic scoring can be used as an effective tool for the evaluation of malignancy in solitary thyroid nodule addition to tests such as FNAC.

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