Ultrasonography and scintigraphic findings in patients presenting with thyroid diseases at muhimbili national hospitals and ocean road cancer institute

Abstract

Background: Thyroid diseases are common and serious diseases in the world and because of this fact, early diagnosis is necessary. Clinicians in our settings rely on clinical presentation, physical examination and biochemical findings in diagnosing patients with thyroid mass and sometimes this leads to misdiagnosis or late diagnosis of cancerous lesions. Abnormal lymph node sometimes can be mistaken for a thyroid nodule. Clinical examination or biochemical findings becomes difficult to do differentiate between two conditions. Objective: The aim of this study was to determine and compare ultrasound and scintigraphy findings in patients presenting with thyroid disease. Methodology; A prospective study of 66 patient was done for a period of 6 months at Muhimbili National Hospital and Ocean Road Cancer Institute. Ultra-sonographic and scintigraphy findings of patients presenting with thyroid disease were done. Ultrasound scanning were done by Principle researcher and scintigraphy scanning were done by Radiographer and Result interpreted by principle researcher and senior radiologist. Results; In this study, females were commonly affected by thyroid disease as compared with males. Out of 66 participants who attended 59 were females (89.4%). Prevalence of disease increases with age up to the age of 60 years with the mean age of 46.98 years (13.88 SD) The most common clinical presentation in the patients who presented with thyroid diseases was neck swelling (Diffuse and Nodular). Other clinical presentations were dysphagia, hoarseness of voice, palpitation, and proptosis. The most common thyroid disease diagnosed by sonography was multinodular goiter (60.6%) which had enlarged thyroid lobes with multiple nodules as the common sonographic findings. Graves' disease and Thyroiditis closely shared similar sonographic findings like diffuse lobe enlargement, heterogeneous echotexture, reduced intraparenchymal echogenicity and increase in Doppler flow. These findings made it hard to distinguish the two conditions preciselyby sonography. Thyroid cancer was diagnosed in 7.6% of the patients and this condition sharedmicro calcification and nodular irregularity in sonographic findings Use of scintigraphy as the gold standard made it possible to differentiate thyroid diseases seen by ultrasound. Multinodular goiter was found to have heterogeneous radiotracer uptake and more increased uptake was seen in toxic multinodular goiter. It was difficult to differentiate sub-acute thyroiditis from silent thyroiditis since both of them showed decreased radiotracer uptake and the only differentiation relies on patient recovery. Graves' disease and Hashimoto thyroiditis both showed an increase in radiotracer uptake. No radiotracer uptake was seen in the patients who had thyroid cancer. Conclusions; In conclusion, the results of this study confirm that thyroid ultrasound and scintigraphy can detect thyroid diseases The accuracy of diagnosis for thyroid diseases increases when both modalities of diagnosis are used together. Sonography which is noninvasive imaging procedure that can safely be performed in critically ill patients should be the initial investigation process in patients presenting with thyroid disease and scintigraphy should be used as a complementary tool