Differential diagnostic value of contrast-enhanced ultrasonography in thyroid nodules

Abstract

Objective To investigate the value of contrast-enhanced ultrasonography(CEUS) in the diagnosis of thyroid nodules under Thyroid Imaging Reporting and Data System (TI-RADS) classification. Methods Totally 295 patients were enrolled, 387 thyroid nodules underwent conventional ultrasonic TI-RADS classification CEUS.In order to observe the microcirculation perfusion characteristics of thyroid nodules, the time intensity curve was obtained by CAP SonoLiver software and compare with postoperative pathologic results.The quantitative parameters of the intensity curves were analyzed, and the two TI-RADS classification were performed.The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of diagnosis of thyroid malignant nodules were calculated by conventional ultrasonic TI-RADS as well as the two TI-RADS classification.Meanwhile the TI-RADS (ROC) curves were plotted, and the area under the ROC curve was calculated. Results Three hundred and eight-seven conventional classification of TI-RADS 2~5 classes of thyroid nodules in 295 patients′ postoperative pathology were analyzed, 121 cases in 82 patients were malignant and 213 cases in 266 patients were benign.The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of conventional ultrasound TI-RADS classification for diagnosis of malignant nodules were 63.64% (77/121), 73.87% (229/310), 79.07% (306/387), 45.83% (77/168), and 83.88% (229/273), while the two TI-RADS classification for diagnosis of malignant nodules were 85.95% (104/121), 92.93% (263/283), 94.83% (263/387), 83.87% (104/124), and 93.93% (263/280). The sensitivity, specificity, accuracy, positive predictive value, positive predictive value and negative predictive value of the two TI-RADS classification of thyroid malignant nodules were higher than those of conventional ultrasound(χ2=5.92, 4.38, 7.31, 7.45, 3.13; P 0.05). Conclusion CEUS can improve accuracy in TI-RADS classification of thyroid nodules. Key words: Ultrasonography; Thyroid nodule; Thyroid imaging reporting and data system classification