Difference between ultrasonic guidance-fine needle aspiration biopsy and contrast-enhanced ultrasound in differential diagnosis of benign and malignant thyroid nodules

Abstract

Objective To explore the value of ultrasonic guidance-fine needle aspiration biopsy (UG-FNAB) and contrast-enhanced ultrasound (CEUS) in the differential diagnosis of benign and malignant thyroid nodules. Methods The clinical data of 160 patients (186 nodules) with conventional ultrasound suspected malignant thyroid nodules from January to December 2016 in Central Hospital of Enshi Autonomous Prefecture were retrospectively analyzed. The pathological results were used as the diagnostic gold standard to compare the value of UG-FNAB and CEUS in the differential diagnosis of benign and malignant thyroid nodules. Results Malignant thyroid nodules were characterized by low enhancement, uneven enhancement, unclear boundary and slow enhancement. The incidences in malignant thyroid nodules were significantly higher than those in benign thyroid nodules, and there were statistical differences (P 0.05). The sensitivity of CEUS in the diagnosis of benign and malignant thyroid nodules was 75.56% (98/128), the specificity was 72.41% (42/58), the missed diagnosis rate was 23.44% (30/128), the misdiagnosis rate was 27.59% (16/58), the positive predictive value was 85.96% (98/114), and the negative predictive value was 58.33% (42/72); the sensitivity of UG-FNAB in the diagnosis of benign and malignant thyroid nodules was 93.75% (120/128), the specificity was 93.10% (54/58), the missed diagnosis rate was 6.25% (8/128), the misdiagnosis rate was 6.90% (4/58), the positive predictive value was 96.77% (120/124), and the negative predictive value was 87.10% (54/62). The sensitivity and specificity of UG-FNAB in the diagnosis of benign and malignant thyroid nodules were significantly higher than those in CEUS, and there were statistical differences (χ2= 14.957 and 8.700, P < 0.01). Conclusions Malignant thyroid nodules has unique CEUS characteristics. UG-FNAB has higher sensitivity and specificity in the differential diagnosis of benign and malignant thyroid nodules, compared with CEUS. Key words: Biopsy, needle; Thyroid nodule; Ultrasonography; Diagnosis, differential