Type:
Educational Exhibit
Keywords:
Ear / Nose / Throat, Head and neck, Thyroid / Parathyroids, Ultrasound-Colour Doppler, Ultrasound-Power Doppler, Ultrasound-Spectral Doppler, Diagnostic procedure, Education, Technical aspects, Education and training, Endocrine disorders, Image registration
Authors:
P. C. Francolin, L. C. C. Chierighini, W. Iared, M. C. Chammas, G. G. Cerri; São Paulo/BR
DOI:
10.26044/ecr2019/C-2600
Conclusion
Color mapping and spectral Doppler analysis are useful tools in addition to the B mode ultrasound evaluation of the thyroid. Due to its non-invasive character and the wide availability at low cost,
morphological evaluation of the thyroid can be routinely associated.
The method allows to determine the vascularization in the thyroiditis,
with better targeting of the diagnosis.
The systolic peak velocity is an additional parameter in the differential diagnosis of difuse thyroid diseases,
as well as in the evaluation of the effectiveness and adherence to the treatment,
together with the hormonal serum thyroid dosages.
Finally,
Doppler evaluation may improve the assessment of thyroid nodules risk helping to decide which nodules should be punctured and wich ones can be monitored (evolutionary control).
Doppler analysis can also help decision making of surgical removal or only surveillance of nodules with inconclusive cytological results. It is important to remember that the Dopplervelocimetric evaluation does not replace the cytological evaluation,
only consisting of a screening method for suspicious nodules.
The standardization of photographic recording (following the standards recommended by the responsible society in each country) gives the study credibility,
making it reproducible,
and giving it the quality mark necessary for its medical-legal validation in eventual professional defense.
Regarding the report,
we recommend that standards follow legal society guidelines.
However,
we must not forget to describe the pattern of color Doppler mapping and the systolic peak velocities in the thyroid arteries.
In patients with nodules,
we recommend to inform the flow patterns using Chammas classification.
The estimated mean resistance index is an additional information that can help assessing the risk in nodules with borderline characteristics. If any nodule has Dopplervelocimetric and/or B-mode criteria for elevated risk,
we recommend to include the information in the report.
The classification of the findings by the parameters recommended by TIRADS is an evolving reality in the diagnostic environment,
aiding at the standardization of the report and in the diagnostic algorithm.
Color and pulsed Doppler could participate within the evaluation by TIRADS criteria,
as an additional tool in the evaluation of thyroid nodules risk.