[Vascularization of single thyroid nodule as an indicator malignant neoplasm: a study using echo-color-Doppler].

A number of studies done with color-flow Doppler (CFD) sonography have disclosed intense vascularization of malignant thyroid nodules. As this method might be able to provide important reference data to enable differentiation between benign and malignant nodular pathology, a study of the vascularization of single thyroid nodules using CFD sonography was done at the Endocrinology Out-Patient Clinic of the Combined Units of the University of Padua and the City Hospital of Venice, 1st Medical Division. Its aim was to verify the utility of CFD in the diagnosis of solitary and scintigraphically "cold" thyroid nodules, particularly to distinguish benign from malignant nodular pathology. One hundred nineteen patients were examined with hormonal dosage, scintigraphy, fine-needle aspiration biopsy (FNAB), echography and CFD sonography of the thyroid, and, in some cases, histological examination. Nineteen patients underwent histological examination: 17 follicular adenomas and 2 papillary carcinomas were found. Color-flow Doppler sonography indicated intense intranodular vascularization in both cases of malignant neoplasm (sensitivity 100%) and in 2 cases of the 17 benign lesions (specificity 88.2%). Moreover, intralesional hypervascularization was not observed in the 2 false positive FNAB cases. Although limited by the scarcity of histological material and the absence of cases of follicular carcinoma, this study has demonstrated that CFD sonography is a highly sensitive (no false negatives) and specific (only 2 false positives) method to diagnose scintigraphically "cold" single thyroid nodules.