Aims and objectives
To assess the diagnositic value of contrast enhanced ultrasound(CEUS) combined with shear wave elastography(SWE) in diagnosing thyroid nodules in category 3 and 4.
Methods and materials
89 thyroid nodules in 86 patients which were classified as TI-RADS category 3 or 4 by a skilled doctor were detected by CEUS and SWE examination respectively and confirmed by surgical and pathological findings.The enhancement patterns were recorded as follows:enhancement time(contrasted with the normal thyroid),peak intensity,enhancement homogeneousness,post-enhancement margin,post-enhancement region,enhancement style(whether it was ring enhancement,whether it was centripetal enhancement).The SWE examinations were performed 20 minutes later.The average value of MEAN(MEANavg),MIN(MINavg),
MAX(MAXavg) and SD(SDavg) of the nodules and the difference value between nodules and the normal thyroid(MEANd,MINd,MAXd,SDd)...
Results
29 benign nodules and 14 malignant nodules were in category 3 and 15 benign nodules and 31 malignant nodules were in category 4.The maximum diameter of the nodules was 2.30-28.50mm(9.09±5.01mm for average).The results of Logistic regression analysis for CEUS showed:the most effective variable were post-enhancement region,enhancement time and peak intensity(P<0.05).The sensitivity,specificity,accuracy,PPV,NPV and area under the curve(AUC)of it were 82.2%,
72.7% ,77.5%,
82.2%,
72.7% and 0.850(95%CI=0.770-0.930) respectively.According to the SWE results,
the sensitivity,specificity,accuracy,PPV,NPV and AUC were 66.7%,
93.2%,
79.8%,
90.9%,
73.2% and 0.863(95%CI=0.788-0.937) respectively taking MAXd=28.18kPa(which...
Conclusion
The combination of contrast enhanced ultrasound and shear wave elastography is remarkably significant in differential diagnosis of TI-RADS category 3 and 4 nodules and worth clinical promotion and application which can also be added into TI-RADS category.
References
[1] Stanicić J,
Prpić M,
Jukić T,
Borić M,
Kusić Z (2009) Thyroid nodularity - true epidemic or improved diagnostics.
Acta Clin Croat 48: 413-418.
PubMed: 20405636.
[2] Zou S,
Wu F,
Guo C,
Song J,
Huang C et al.
(2012) Iodine nutrition and the prevalence of thyroid disease after salt iodization: a cross-sectional survey in Shanghai,
a coastal area in China.
PLOS ONE.
7(7): e40718.
doi:10.1371/journal.pone.0040718.
PubMed: 22911705.
[3] Cramer JD,
Fu P,
Harth KC,
Margevicius S,
Wilhelm SM.
Analysis of the rising incidence...