البحث السادس
أهمية الدوبلر الملون في التمييز بين الأورام الحميدة و الخبيثة في الغدة الدرقية
بحث مشترك في مجلة الزقازيق الطبية
اصدار خاص نوفمبر 2004
Value of Color Doppler Sonography Alone or in Combination with Gray Scale One in Diagnosis of Malignant Cold Solitary Solid Thyroid Nodule.
Osama Taha Galal , MD, Ahmed El shal , MD*Yasser H Mohamed , MD* and Sobhy Abou El- Fotouh , MD*
Diagnostic radiology and Otorhinolaryngolgy*Departments – Benha Fuculty of medicine , Zagazig University.

Abstract
The purpose of this study was to provide Color Flow Doppler (CFD) 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 .Sonographic findings that suggested malignancy included microcalcifation , an irregular or microlobulated margin , marked hypoechogenicity , a shape that more tall than it was wide and type III Color Flow pattern were recorded.If even one of these sonographic 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) . Hemithyroidectomy was done for all cases with solitary nodule . The final diagnosis of a feature as benign or malignant was confirmed by histopathological examination to the excised specimens.
The sensitivity , specificity and accuracy were then calculated on the basis of our proposed classification method .Of 9 histopathologically malignant cases , 8 were classified as positive . 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 74.4% .

Conclusion: No single Ultrasound (US) criterion is reliable in differentiating benign from malignant nodule . The Color Flow 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 .