Diagnostic Utility of Multiparametric Ultrasonography in the Evaluation of Diffuse and Nodular Thyroid Disorders

Abstract

Background: Thyroid disorders are among the most prevalent endocrine abnormalities, manifesting as diffuse or nodular glandular changes. Ultrasonography (USG) is widely utilized as the first-line imaging modality for thyroid evaluation due to its non-invasiveness and high resolution. The advent of multiparametric ultrasonography— encompassing gray-scale imaging, color Doppler, elastography, and contrast-enhanced ultrasound (CEUS)—has significantly improved lesion characterization, enabling better differentiation between benign and malignant pathologies. This study aims to evaluate the diagnostic utility of multiparametric ultrasonography in assessing parenchymal thyroid diseases and correlating sonographic findings with clinical and cytological outcomes. Aims and Objectives: To assess the effectiveness of multiparametric ultrasonography in characterizing parenchymal thyroid diseases, including diffuse and nodular abnormalities, and to correlate ultrasonographic findings with cytopathological results for diagnostic validation. Materials and Methods: This hospital-based prospective study was conducted in the Department of Radiology, Netaji Subhas Medical College and Hospital, Bihta, Patna. Seventy-five patients with clinically suspected thyroid disorders underwent multiparametric ultrasonography including gray-scale, color Doppler, and elastography assessment. Fine needle aspiration cytology (FNAC) or histopathology was performed where indicated. Imaging features were evaluated based on echotexture, vascularity, stiffness score, nodule size, margins, and calcifications. Correlation with cytological diagnosis was done for diagnostic accuracy analysis. Results: Out of 75 patients, 42 presented with nodular thyroid disease and 33 with diffuse parenchymal involvement. Among nodular cases, 28 nodules were benign, 10 were indeterminate, and 4 were malignant on cytology. Elastography and Doppler findings showed significant correlation with malignant features—malignant nodules demonstrated higher stiffness and intranodular vascularity. In diffuse thyroid diseases, heterogeneous echotexture with increased vascularity was commonly seen in Graves’ disease, while Hashimoto thyroiditis showed hypoechoic texture with coarse echotexture and reduced flow in later stages. Conclusion: Multiparametric ultrasonography provides a comprehensive, non-invasive approach to evaluating thyroid parenchymal diseases. The combination of grayscale, Doppler, and elastography significantly enhances diagnostic confidence, especially in differentiating benign from malignant nodules and characterizing diffuse thyroid pathology. Routine use of multiparametric USG may reduce unnecessary FNACs and improve early disease recognition