The evaluation of the relationship between the vascularity patterns and the doppler flow paramethers with the pathology results of thyroid nodules

Objective: To search the relationship between the vascularity patterns, the resistive and pulsatility indexes and peak systolic velocity with the pathology results and to increase the efficiency of biopsy by suggesting the nodule with high risk of malignancy in multinodular goiter cases.Materials and Methods: One hundred and fourteen nodules of 95 patients were classified as vascularity patterns of those which internal vascularity increase from 1 to 5 and then as combining those having internal vascularity. The mean values of vascularized 99 nodules are computed after getting the resistive and pulsatility indexes with peak systolic velocities in central and/or in the peripheral of the nodule.Results: A statistically significant relationship was obtained between the benignity, suspicious malignancy and malignancy with the vascularity of nodules.(P=0.028). The pathology result in % 88.4 of the nodules with pattern 2, %85.2 of the nodules with pattern 3 and % 60 of the nodules with pattern 5 was benign. The nodules with pattern 1 in both classification was benign. The relationship between the the nodules and the benignity was presented more powerfully as %97.7 in nodules with pattern 2, %90.7 in nodules with pattern 3. %7.4 of the nodules with pattern 3 took place in suspicious malignant group. Patern 3 is observed in one of the two malignant cases and pattern 4 in the other. Both of the malignant cases took place in the centrally vascularized group in both of the classifications. The mean RI was 0.63 in benign and suspicious malignant nodules, 0.67 in malignant nodules; the mean PI was 0.96 in benign nodules, 0.95 in suspicious malignant nodules and 1.02 in malignant nodules; the mean peak systolic velocity was 24 cm/ sec in the malignant and 38 cm/sec in benign nodules.Conclusion: Peripherally vascularization of a thyroid nodule highly indicates benignity but also may be found in malignant nodules. Even though it is not significant statistically,a thyroid nodule having mixed vascularization thought to be more meaningful for malignancy, instead of having only peripheral or central vascularization. The mean resistive index, peak systolic velocity, pulsatility index of thyroid nodules are not usefull paramethers for predicting malignancy risk before biopsy.Key Words: Vascularization pattern, resistive index, peak systolic velocity, pulsatility index