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Sonographic Evaluation of Thyroid Nodules with Elastography and Cytopathological Correlation
P B Abinaya1, Lavanya Dharmalingam2, Siva Kaliyamoorthy3
1Post Graduate, Department of Radiodiagnosis, Aarupadai Veedu Medical College and Hospital, Vinayaka Missions Research Foundation (Deemed to be University), Puducherry, India.
Background:
Thyroid nodules are commonly detected with high-resolution ultrasonography. While most are benign, a significant minority are malignant, necessitating accurate risk stratification. Conventional ultrasound is sensitive but has limited specificity due to overlapping features.
Aim:
To assess the diagnostic accuracy of ultrasound elastography in thyroid nodules by correlating elastography findings with cytopathology.
Materials And Methods:
This analytical cross-sectional study included 100 patients (20-60 years) with thyroid nodules evaluated using B-mode ultrasound and TI-RADS classification. Shear wave elastography was performed to assess tissue stiffness. Nodules with suspicious features underwent ultrasound-guided FNAC, reported using the Bethesda system. Statistical analysis was done using SPSS v26.0, with significance set at P < 0.05.
Results:
The mean age was 39.16 ± 12.24 years, with female predominance. Most nodules were hypoechoic, and 22% were TI-RADS 5. Elastography identified 28% of nodules as stiff. Cytopathology showed 56% benign and 44% malignant lesions. A weak but statistically significant negative correlation was observed between elastography findings and cytopathology (P = 0.05).
Conclusion:
The combined use of ultrasonography, shear wave elastography, and cytopathology enhances thyroid nodule characterization. Elastography is a valuable adjunct to conventional ultrasound and FNAC, supporting improved risk stratification and clinical decision-making.
