A Comparison Study of Ultrasonography Characteristics of Malignant and Non Malignant Thyroid Nodules in Udonthani Hospital

Abstract

Thyroid nodules constitute a significant public health concern which frequently encountered in clinical practice in Thailand. Ultrasonography of thyroid nodules plays a pivotal role in disease diagnosis and subsequent treatment planning. This study aimed to comparatively analyze ultrasonographic characteristics of malignant and non malignant thyroid nodules in Udonthani hospital. This retrospective descriptive study reviewed medical records and imaging data from department of Radiology, Udonthani hospital. It included 193 patients with thyroid nodules who underwent ultrasonographic evaluation by radiologists and subsequent pathological assessment between January 1^st, 2023, and December 31^th, 2023. Statistical comparisons were performed using Pearson’s Chi-square or Fisher’s exact tests to assess differences in proportions. Univariate and multivariate logistic regression analysis were conducted to identify ultrasonographic characteristics significantly associated with malignancy, with a p-value < 0.05 considered statistically significant.                                                                                                          

       Results This study comprised 193 patients, of whom 52.8% were female, with a mean age of 43.2 ± 7.9 year old. Malignant thyroid nodules were identified in 121 patients, whereas non malignant nodules were found in 72 patients. Multivariate logistic regression analysis identified ultrasonographic characteristics as significantly associated with malignant thyroid nodules, as follows, solid nodules (AOR 5.7, 95% CI 0.3– 10.2, p-value 0.043), hypoechoic nodules (AOR 6.6, 95% CI 1.0– 41.9, p-value 0.046), ill defined nodules (AOR 6.9, 95% CI 0.7- 14.8, p-value 0.048), taller than wide nodules (AOR 7.6, 95% CI 1.5– 65.5, p-value < 0.001), increased vascularity nodules (AOR 12.8, 95% CI 1.8– 90.3, p-value 0.010) and abnormal cervical lymph nodes (AOR 21.7, 95% CI 3.6– 130.1, p-value < 0.001).                                                                                                                          

       Conclusion The specific ultrasonographic characteristics significantly associated with malignant thyroid nodules were solid nodules, hypoechoic nodules, ill defined nodules, taller than wide nodules, increased vascularity nodules and abnormal cervical lymph nodes. These findings offer crucial diagnostic insights, enabling clinicians to better determine the necessity for pathological evaluation and formulate effective management strategies.