Champa Rani, Parkash Lal, Tariq Mahmood.
Comparative study for the evaluation of solitary thyroid nodule: ultrasonography versus fine needle aspiration cytology.
Pak J Surg Jan ;30(1):14-7.

Objective: To determine the accuracy of two diagnostic modalities in solitary thyroid nodule. Design: Prospective observational study. Sett ing: Th is study was carried out at department of diagnostic Radiology, Jinnah Postgraduate Medical Center Karachi from February 2012 to January 2013. Methodology: A total of 192 patients referred from surgical out patients departments underwent ultrasonographic evaluation of solitary thyroid nodule in the department of diagnostic radiology meeting the inclusion and exclusion criteria were included in this study. Ultrasonographic features; irregular margin, micro calcifi cations and echogencity of each nodule were recorded. Based on ultrasonographic features nodule was classifi ed as benign or malignant. Fine needle aspiration cytology FNAC by using 22-guage needle was performed on each solitary thyroid nodule (STN) to confi rm ultrasonographic diagnosis. Results: Total numbers of patients were 192 and average age of the patients is 36.33 ± 9.15 years. 30.61% were males and 69.39% females. Male to female ratio was 1.0:2.3. 54.4% patients had duration of complaints less than 10 months while 45.6% had more than 10 months. Hypoechogenicity in solitary thyroid nodule was observed in 15.6% patients, micro calcifi cation in 11.4% and irregular margin appearance in 8.3% patients. Ultrasonography labeled benign nodules in 76.1% patients and malignant in 23.9 % patients while fi ne needle aspiration cytology FNAC conformed benign nodule in 90.6% and malignant in 9.4% patients. Sensitivity, specifi city, positive and negative predictive value as well as accuracy of US in detection of malignant thyroid nodule was 83.3%, 82.7%, 33.3%, 98% and 83% respectively. Conclusion: Ultrasonography is a useful investigation for the evaluation of benign solitary thyroid nodules but it should be done in conjunction with FNAC when there is hypo echoic appearance, Micro calcifi cation and irregular margin appearance observed in nodules

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