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Clinical value of contrast-enhanced ultrasonography in focal hypoechogenic lesions of thyroid

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Abstract

Objective

The objectives of this study were to analyze the accuracy of contrast-enhanced ultrasonography (CE-US) in diagnosing focal hypoechogenic lesions of the thyroid (FHLT), and to explore the clinical value of CE-US in the diagnosis of FHLT.

Methods

Patients undergoing CE-US and ultrasound-guided fine needle aspiration (US-FNA) of FHLT at First Hospital of China Medical University between January 2017 and December 2018 were selected for the study; this included patients with papillary thyroid carcinoma (PTC), subacute thyroiditis (SAT) and focal Hashimoto thyroiditis (FHT). All patients underwent color Doppler ultrasonography (CD-US) after which thyroid image reporting and data system (TI-RADS) grading were done. Then, each patient underwent CE-US and US-FNA. The results of the CE-US were analyzed using descriptive statistics. The cytopathological results from the US-FNAs were the gold standard used to confirm the diagnoses.

Results

A total of 56 patients were selected for the study. In the PTC group (n = 16), grading was as follows: TI-RADS4a, n = 3; TI-RADS4b, n = 12; and TI-RADS4c, n = 1. More patients with PTC showed heterogeneous hypoenhancement (n = 15) than heterogeneous isoenhancement (n = 1) on CE-US. In the SAT group (n = 24), grading was as follows: TI-RADS3, n = 1; TI-RADS4a, n = 18; TI-RADS4b, n = 5. Fewer patients with SAT showed heterogeneous hypoenhancement (n = 2) than heterogeneous isoenhancement (n = 22) on CE-US. In the FHT group (n = 16), grading was as follows: TI-RADS3, n = 1; TI-RADS4a, n = 11; TI-RADS4b, n = 4. Of those in the FHT group, one patient showed heterogeneous isoenhancement, one patient showed heterogeneous hypoenhancement, and 14 showed uniform isoenhancement on CE-US. The diagnostic accuracy of CD-US alone differed significantly from that of CD-US + CE-US (p < 0.05).

Conclusion

CE-US has a high diagnostic accuracy for FHLT and can be used to identify PTC, SAT, and FHT.

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Acknowledgements

This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

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Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, People’s Republic of China

    Songnian Liang

  2. Department of Ultrasonic Diagnosis, Liaoning Province Cancer Hospital and Institute, Shenyang, Liaoning, People’s Republic of China

    Ningning Gao

  3. Department of Ultrasonic Diagnosis, The First Affiliated Hospital of China Medical University, Nanjingbei Street 155#, Shenyang, Liaoning, People’s Republic of China

    Donglin Bian, Qixi Zhai, Puxu Yang & Kun Huang

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  1. Songnian Liang
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Correspondence to Kun Huang.

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Liang, S., Gao, N., Bian, D. et al. Clinical value of contrast-enhanced ultrasonography in focal hypoechogenic lesions of thyroid. Eur Arch Otorhinolaryngol 279, 2077–2082 (2022). https://doi.org/10.1007/s00405-021-06982-4

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  • DOI: https://doi.org/10.1007/s00405-021-06982-4

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