A comparative study of high resolution ultrasound, ultrasound elasticity imaging, and contrast-enhanced ultrasound in the differential diagnosis of benign and malignant lesions in thyroid nodules

Abstract

Objective To determine the diagnostic criteria of high resolution ultrasound,ultrasound elasticity imaging,and contrast-enhanced ultrasound in the differential diagnosis of benign and malignant lesions in thyroid nodules and assess their clinical efficacy.Method Sixty-three patients with thyroid nodules underwent high resolution ultrasound,elasticity imaging,and contrast-enhanced ultrasound examinations before surgery.Distinguishing benign from malignant lesions was based on pathological results.Valuable indicators from the examinations were screened and patients' occupational characteristic curves were made.Results (1) The significant indicators of high resolution ultrasound in differential diagnosis of thyroid nodules were hypoechoic nodules,uneven echo,ill-defined,irregular shape,aspect ratio ≥ 1 and punctate calcification within the nodule (P＜0.05).(2) The elastosonography grading score had significant differences between benign and malignant lesions (P＜0.05).(3) The meaningful indicators of contrast-enhanced ultrasound were the unclear enhanced border and the irregular enhanced shape (P＜0.05).(4) The diagnostic criteria of high-resolution ultrasound met any three of six indicators,with the sensitivity,specificity,and accuracy of 80.0％,77.6％,and 78.6％ respectively.The diagnostic criterion of elastography was the elasticity score ≥ 3 points,with the sensitivity,specificity,and accuracy were 48.6％,83.7％,and 69.0％ respectively.The diagnostic criteria of contrast-enhanced ultrasound were complying with any one of two indicators,with the sensitivity,specificity,and accuracy of 68.6％,82.5％,and 76.0％ respectively.Conclusions The high-resolution ultrasound may yield higher sensitivity and accuracy in the differential diagnosis of benign and malignant lesions in thyroid nodules,while ultrasound elasticity imaging and contrast-enhanced ultrasound may offer a higher specificity. Key words: Thyroid nodules ; High resolution ultrasound ; Ultrasound elasticity imaging ; Contrast-enhanced ultrasound