Diagnostic value of contrast-enhanced ultrasound combined with fine-needle aspiration for thyroid cancer

Abstract

Objective To evaluate the diagnostic value of the contrast-enhanced ultrasound (CEUS) combined with ultrasound-guided fine needle aspiration biopsy (FNA) for thyroid carcinoma.Methods A retrospective analysis of the clinical data of 165 patients was finished,including 184 thyroid nodules confirmed by pathology (14 benign,170 malignant) and their preoperative FNA and CEUS data.According to the maximal diameter of thyroid nodules,the patients was divided into group A (≤ 1 cm) and group B (＞1 cm).According to the Bethesda System,＞grade Ⅳ was the malignant cytologic criteria for diagnosis of thyroid nodules,and uneven low-enhanced ultrasound was the standard diagnosis of malignant thyroid.Pursuant to which,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of diagnosis for thyroid nodules by FNA,CEUS,and the combination were analyzed respectively.Results In group A,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of single FNA were 93.8％,62.5％,92.0％,97.6％,38.5％,and CEUS diagnosis for thyroid cancer were 88.5％,37.5％,85.5％,95.8％,16.7％,respectively.After FNA and CEUS were combined,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 100％,25.0％,95.7％,95.6％,100％,respectively.When the combined diagnosis compared with single FNA and CEUS,the sensitivity and accuracy were statistically significant (P =0.013,0.000 and P =0.000,0.000).In group B,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of single FNA were 100％,83.3％,97.8％,97.6％,100％,and CEUS diagnosis for thyroid cancer were 92.5％,83.3％,91.3％,97.4％,62.5％,respectively.After FNA and CEUS were combined,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 100％,66.7％,95.6％,95.2％,100％,respectively.For each pairwise comparison,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value were not statistically different (P ＞0.05).Conclusions For thyroid nodules ≤ 1cm,the combined diagnosis of FNA and CEUS can significantly improve the diagnostic sensitivity and accuracy.While for thyroid nodules ＞ 1 cm,the combined diagnosis does not change the diagnostic accuracy,sensitivity and specificity. Key words: Ultrasonography; Microbubbles ; Biopsy, needle; Thyroid neoplasms