Evaluation of CEUS features and related biological behaviors in patients with benign and malignant thyroid nodules

Abstract

Objective To investigate the value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of benign and malignant thyroid nodules. Methods A total of 113 patients with thyroid nodules from November 2016 to July 2018 were enrolled in our hospital. There were 139 nodules, including 83 benign nodules and 56 malignant nodules. All patients underwent conventional ultrasound and CEUS examinations to statistically analyze the CEUS enhancement phase of different thyroid nodules [contrast agent into nodule time (slow progression, synchronization, fast forward), peak time (slower, synchronous, faster than), regression time (slow retreat, synchronization, early retreat)], internal and marginal enhancement features of different thyroid nodules [post-contrast boundary (unclear, clear), annular enhancement (none, yes), uniformity (uneven, uniform), peak intensity (high, equal, low), entry mode (diffuse, centripetal)], and statistical comparison of conventional ultrasound and CEUS on the diagnosis of benign and malignant thyroid nodules. Results ⑴ CEUS enhancement phase of different thyroid nodules: malignant nodules contrast agent entered the nodule time, peak time, regression time and benign nodules were significantly different (P<0.05); ⑵ Enhanced features of internal and margin of thyroid nodules with different nature: significant differences between borders, ring enhancement, uniformity, peak intensity, entry pattern and benign nodules after malignant nodule contrast (P<0.05); centripetal entry mode (67.86%), border ambiguity rate after angiography (83.93%), no ring enhancement rate (100.00%), unevenness (75.00%) in malignant nodules was significantly higher than those in benign nodules (P<0.05); ⑶ conventional ultrasound and CEUS pair diagnostic efficacy of benign and malignant thyroid nodules: CEUS has a sensitivity (91.07%), specificity (97.59%), and accuracy (94.96%) for thyroid malignant nodules, which was higher than that in conventional ultrasound (60.71%, 87.95%, 76.98%) (P<0.05). Conclusions CEUS examination can effectively present different features of malignant thyroid nodules and benign nodules. There are significant differences between enhanced phase, internal and marginal enhancement features, with high diagnostic sensitivity, specificity and accuracy to avoid missed diagnosis and misdiagnosis, and provide a reference for clinical formulation and adjustment of effective treatment plans. Key words: Thyroid nodule; Ultrasonography; Contrast media; Diagnostic imaging