Improvement of diagnostic efficiency in distinguishing the benign and malignant thyroid nodules via conventional ultrasound combined with ultrasound contrast and elastography

Abstract

We aimed to evaluate the diagnostic values of conventional ultrasound (US), ultrasound contrast (UC) and ultrasound elastography (UE) in distinguishing the benign and malignant thyroid nodules. A total of 100 patients with thyroid nodules receiving operative treatment were selected; they underwent the conventional US, UE and UC examinations before operation, respectively. The nodules received pathological examination after operation to distinguish benign from malignant lesions. The sensitivity, specificity and diagnostic accordance rate of each diagnostic method was evaluated by receiver operating characteristic (ROC) curve, and the area under the curve (AUC) of ROC was calculated. The manifestations of malignant thyroid nodules in conventional US examination were mostly the hypoecho, heterogeneous echo, irregular shape, unclear boundary, aspect ratio <1, microcalcification and irregular peripheral echo halo, and there were statistically significant differences compared with the benign nodules (P<0.05). UE showed that the differences between benign and malignant nodules in 2, 3 and 4 points were statistically significant (P<0.05). The manifestations of malignant nodules in UC were mostly the irregular shape, obscure boundary, no obvious enhancement, heterogeneous enhancement and visible perfusion defects, and there were statistically significant differences compared with the benign nodules (P<0.05). ROC curve showed that both sensitivity and specificity of UE and UC were superior to those of conventional US. AUC was the largest (AUC = 0.908) and the diagnostic value was the highest in the conventional US combined with UE and UC. Conventional US combined with elastography and UC can significantly improve the sensitivity, specificity and accuracy of diagnosis of benign and malignant thyroid nodules.

Evaluating breast ultrasound S-detect image analysis for small focal breast lesions

“…US evaluation is principally utilized to characterize two-dimensional lesion morphology, but can be extended to use elastography or acoustic radiation force impulse imaging (ARFI) to assess tissue stiffness, and three-dimensional US (3D-US) can yield more detailed imaging. As part of the breast cancer screening armamentarium, US has contributed to earlier diagnosis, which facilitates more conservative and more effective treatment with commensurate improved patient outcomes ( 2 , 3 ). Tumor stage is a critical component of patient survival, as illustrated by the 10-year overall (OA) survival rate of 81%–93% in patients with breast cancers measuring ≤2 cm, compared to the OA rate of 60%–70% with cancers >2 cm ( 4 , 5 ).…”

Distinguishing mummified thyroid nodules from malignant thyroid nodules

“…The halo sign is a nonspecific manifestation of a mummified nodule. Experts have differing opinions regarding the value of the halo sign in distinguishing benign from malignant nodules [10][11][12][13][14]. Lacout et al [6] considered that the halo sign is related to the development of tissue granulation and the formation of a fibrous capsule.…”

Value of differential diagnosis of contrast‑enhanced ultrasound in benign and malignant thyroid nodules with microcalcification

“…In the malignant thyroid nodules with microcalcification, the existence of gravel-like calcium oxalate crystals can inhibit neovascularization inside the thyroid nodules and cause a lack of blood supply in the tumor (14). Furthermore, due to the very rapid cell proliferation of malignant thyroid tumors, the massive blood vessels inside the tumor have relatively small diameters and tortuous courses, which generate a great resistance to reduce the flow of blood and contrast agent toward the center of the nodules with microcalcification (15).…”