title: Diagnostic value of contrast-enhanced ultrasound in solid thyroid nodules with and without enhancement.
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.
authors.affiliation: 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.
authors.forename: Qiong
authors.initials: Q
authors.lastname: Wu
authors.affiliation: 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. yannanfly@126.com.
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: 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.
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.affiliation: 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.
authors.forename: Bing
authors.initials: B
authors.lastname: Hu
authors.affiliation: Department of Radiology, Shanghai Jiao Tong University Affiliated First People's Hospital, Shanghai, China.
authors.forename: Zhi-Yan
authors.initials: ZY
authors.lastname: He
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013961:Thyroid Gland / Q000000981:diagnostic imaging* / Q000473:pathology; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: Contrast-enhanced ultrasound; Conventional ultrasound; Sonographic features; Thyroid nodules