Application of high-resolution ultrasound, real-time elastography, and contrast-enhanced ultrasound in differentiating solid thyroid nodules.
High-resolution ultrasound (HRUS) is a sensitive tool for identifying thyroid nodules. Real-time elastography (RTE) and contrast-enhanced ultrasound (CEUS) are newly developed methods which could measure tissue elasticity and perfusion features. The aim of the present study was to evaluate and compare the diagnostic efficiency of HRUS, RTE, CEUS and their combined use in the differentiation of benign and malignant solid thyroid nodules.In total, 111 consecutive patients with 145 thyroid nodules who were scheduled for surgery were included in the study. All of them underwent HRUS, RTE, and CEUS examination. The independent ultrasound (US) predictors for malignancy were determined and quantified using logistic regression analysis, based on which a risk-scoring model was established for each method. The diagnostic efficiency of each method was assessed by receiver operating characteristic (ROC) curve analysis.HRUS showed the best diagnostic efficiency among the 3 US methods, with 74.6% sensitivity and 87.8% specificity. CEUS had higher sensitivity (85.7%), whereas RTE alone did not show much advantage. Combined use of RTE and HRUS increased the sensitivity (92.1%). The HRUS-RTE-CEUS combination could increase both the sensitivity and specificity (87.3%, 91.5%), with the best AUC (0.935) among all the methods.The overall diagnostic value of HRUS in predicting malignancy is the best among the 3 US methods. Combined use of RTE and CEUS and HRUS could improve the diagnostic efficiency for solid thyroid nodules.
Department of Endocrinology Department of Ultrasound Department of General Surgery, the First Affiliated Hospital with Nanjing Medical University Department of Ultrasound, Affiliated Hospital of Integration Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China.
Yu-Zhi
YZ
Zhang
Ting
T
Xu
Hai-Yan
HY
Gong
Cui-Ying
CY
Li
Xin-Hua
XH
Ye
Hong-Jun
HJ
Lin
Mei-Ping
MP
Shen
Yu
Y
Duan
Tao
T
Yang
Xiao-Hong
XH
Wu
D000328:Adult; D003287:Contrast Media; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016606:Thyroid Nodule / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000379:methods
D003287:Contrast Media