<b>Differentiation of Benign and Malignant Thyroid Nodule on the Basis of Vascular Pattern by Using Color Doppler Ultrasonography</b>

Background: Thyroid nodules are frequently encountered in clinical practice, and although most are benign, accurate risk stratification is essential to identify lesions requiring cytological evaluation while avoiding unnecessary invasive procedures. Gray-scale ultrasonography remains the first-line imaging modality, while Color Doppler ultrasonography may provide adjunctive information regarding nodular vascularity. Objective: To evaluate Doppler vascularity patterns in thyroid nodules and determine their association with demographic characteristics, nodule dimensions, and gray-scale sonographic features. Methods: This cross-sectional analytical study included 69 patients aged 18–70 years with clinically or sonographically detected thyroid nodules at Government Teaching Hospital, Shahdara, Lahore. High-resolution ultrasonography with Color Doppler assessment was used to evaluate nodule number, thyroid part involvement, shape, margin, echogenicity, calcification, dimensions, and vascularity. Data were analyzed using IBM SPSS version 25. Categorical associations were assessed using chi-square tests, and age and nodule dimensions were compared across vascularity groups using one-way ANOVA with Tukey post hoc analysis. Results: Females constituted 67 patients (97.1%), and the mean age was 41.67 ± 13.62 years. Minimally present vascularity was the most common Doppler pattern (39.1%), followed by absent (33.3%) and increased vascularity (27.5%). Vascularity was not significantly associated with nodule number, thyroid part involvement, margin, echogenicity, calcification, or shape. Age differed significantly across vascularity groups (p = 0.031), with increased vascularity observed in older patients. Conclusion: Color Doppler vascularity showed limited association with most sonographic features, although increased vascularity was more common in older patients. Doppler assessment may complement gray-scale ultrasound, but vascularity alone cannot reliably differentiate benign and malignant nodules without cytological correlation.