Abstract:
Background: Thyroid nodules are commonly detected in clinical practice, with a significant portion
being benign, but a small percentage harbor malignancy. Accurate evaluation of these nodules is
crucial for guiding management decisions, such as the need for biopsy or surgery. Color Doppler
ultrasound, an advanced imaging technique, is increasingly used to assess thyroid nodules by
evaluating blood flow within the nodule. The aim of this review is to examine the role of color Doppler
ultrasound in the diagnostic workup of thyroid nodules and its effectiveness in differentiating benign
from malignant nodules.
Material and Methods: A review of studies published in medical databases, including PubMed and
Cochrane Library, was conducted to evaluate the utility of color Doppler ultrasound in assessing
thyroid nodules. Key studies focused on the use of Doppler imaging to analyze vascularity patterns in
thyroid nodules and its correlation with malignancy. The review included articles that assessed the
sensitivity, specificity, and overall diagnostic performance of color Doppler in the context of thyroid
nodule evaluation.
Results: Color Doppler ultrasound assesses blood flow within a thyroid nodule, with malignant
nodules often exhibiting abnormal vascular patterns, such as increased peripheral or internal blood
flow. Studies have shown that color Doppler ultrasound can provide additional information beyond
conventional ultrasound, particularly in nodules with ambiguous characteristics. Malignant thyroid
nodules are frequently associated with increased vascularity, irregular blood vessels, or a higher
resistance index in blood flow. Sensitivity and specificity for identifying malignancy using color
Doppler ultrasound vary across studies but generally range from 60% to 90%. However, the technique
is not definitive on its own and is often used in combination with conventional ultrasound features such
as size, shape, and margins of the nodule.
Conclusion: Color Doppler ultrasound is a valuable adjunct in the evaluation of thyroid nodules,
helping to differentiate benign from malignant lesions based on vascular patterns. While it enhances
diagnostic accuracy, especially for nodules with uncertain characteristics, it is not a standalone
diagnostic tool. Color Doppler should be used in conjunction with other imaging modalities like
conventional ultrasound and fine needle aspiration biopsy (FNAB) to improve the overall diagnostic
approach for thyroid nodule evaluation.
