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Diagnostic value of contrast-enhanced ultrasound in solid thyroid nodules with and without enhancement

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Abstract

We aimed to investigate different enhancement patterns of solid thyroid nodules on contrast-enhanced ultrasound (CEUS) and then to evaluate the corresponding diagnostic performance in the differentiation of benign and malignant nodules with and without enhancement. 229 solid thyroid nodules in 196 patients who had undergone both conventional ultrasound and CEUS examinations were classified into enhancement and non-enhancement groups. Besides, different enhancement patterns in the enhancement group were characterised with five indicators including arrival time, mode of entrance, echo intensity, homogeneity, and washout time. Then aforementioned indicators were compared between benign and malignant nodules of different sizes (<10 mm and >10 mm), and diagnostic performance of significant enhancement indicators was calculated. As for the enhancement group, there were statistically significant differences of <10 mm subgroup among three CEUS indicators including arrival time, mode of entrance, and washout time between malignant and benign thyroid nodules (p < 0.05), while all CEUS indicators showed statistically significant differences in the total group and ≥10 mm subgroup (p < 0.05). All the five CEUS indicators displayed better diagnostic performance with specificity (92.86, 92.14, 95.71, 90.71, and 90.71 %, respectively) and diagnostic accuracy (80.79, 79.48, 74.67, 75.11, and 81.66 %, respectively), while the sensitivity and negative predictive value of non-enhancement were 95.51 and 95.83 %, respectively, with an accuracy of 77.29 %. CEUS is a very promising diagnostic technique that could improve the diagnostic accuracy of identifying benign thyroid lesions to spare a large number of patients an unnecessary invasive procedure.

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Abbreviations

CEUS:

Contrast-enhanced ultrasound

FNA:

Fine-needle aspiration

EFSUMB:

The European Federation of Societies for Ultrasound in Medicine and Biology

ROSE:

Rapid onsite evaluation

ROI:

Region of interest

PPV:

Positive predictive value

NPV:

Negative predictive value

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Authors and Affiliations

  1. Department of Ultrasound in Medicine, Shanghai Institute of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai, 200233, China

    Qiong Wu, Yan Wang, Yi Li & Bing Hu

  2. Department of Radiology, Shanghai Jiao Tong University Affiliated First People’s Hospital, Shanghai, China

    Zhi-Yan He

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  1. Qiong Wu
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  2. Yan Wang
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Correspondence to Yan Wang.

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Wu, Q., Wang, Y., Li, Y. et al. Diagnostic value of contrast-enhanced ultrasound in solid thyroid nodules with and without enhancement. Endocrine 53, 480–488 (2016). https://doi.org/10.1007/s12020-015-0850-0

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