ULTRASOUND ASSESSMENT OF EXTERNAL CAROTID ARTERY DOPPLER HEMODYNAMICS IN PATIENTS WITH MALIGNANT THYROID NODULES

Abstract

Thyroid nodules represent a relatively prevalent endocrine disease, with increasing incidence due to the use of high-resolution ultrasonography. Although the majority of nodules are benign, a small but clinically significant proportion are malignant, making early and accurate diagnosis essential. Risk stratification is commonly performed using grayscale ultrasound and Thyroid Imaging Reporting and Data System (TI-RADS); however, their diagnostic accuracy may be limited due to overlapping imaging features.

This study was conducted to evaluate the Doppler hemodynamic parameters of the external carotid artery (ECA) in patients with malignant thyroid nodules and to determine their relationship with TI-RADS classification. A cross-sectional analytical study was carried out on 55 patients with malignant thyroid nodules. All patients underwent grayscale ultrasound, TI-RADS classification, and Doppler examination of the external carotid artery. Doppler parameters including peak systolic velocity (PSV), end diastolic velocity (EDV), and resistive index (RI) were recorded.

The results demonstrated that hypoechogenicity, irregular margins, taller-than-wide shape, and microcalcifications were common grayscale ultrasound findings associated with malignancy. Doppler evaluation showed a mean PSV of 99.49 ± 7.62 cm/s, mean EDV of 27.60 ± 4.18 cm/s, and mean RI of 0.79 ± 0.04. A statistically significant positive correlation was observed between TI-RADS category and PSV (r = 0.41, p = 0.003) as well as RI (r = 0.56, p < 0.001), while no significant association was found with EDV (p = 0.162).

It is concluded that external carotid artery Doppler parameters, particularly PSV and RI, have a strong association with malignant thyroid nodules and can serve as a useful non-invasive adjunct to conventional ultrasound.