Diagnostic Value of Conventional Ultrasonography Combined with Contrast-Enhanced Ultrasonography in Thyroid Imaging Reporting and Data System (TI-RADS) 3 and 4 Thyroid Micronodules

Abstract

BackgroundThe present study was conducted to investigate the diagnostic performance of conventional ultrasonography (US) combined with contrast-enhanced ultrasonography (CEUS) in thyroid micronodules with thyroid imaging reporting and data system (TI-RADS) category 3 and 4.Material/MethodsThe features of conventional US and CEUS ion 102 case of thyroid micronodule samples, which were diagnosed based on pathological and clinical examination, were retrospectively analyzed. Logistic regression analysis was used to analyze the diagnostic accuracy in malignant thyroid micronodules. Receiver operator characteristic (ROC) curve was used to assess the performance of those 2 technologies.ResultsA significant difference in age was found between the benign and malignant groups. The benign and malignant groups showed significant differences in shape, margin, aspect ratio (A/T) ≥1, microcalcification, suspicious lymph gland, enhancement time, enhancement pattern, enhancement intensity, nodule sizes, enhancement margins, and rim-like enhancement. Logistic regression analysis of conventional US showed that A/T ≥1, irregular shape, microcalcification, and suspicious lymph glands are risk factors for thyroid micronodules, while logistic regression analysis of CEUS showed that slow enhancement time and absence of rim-like enhancement are risk factors for thyroid micronodules. Logistic regression analysis of conventional US combined with CEUS demonstrated that A/T ≥1, microcalcification, suspicious lymph gland, slow enhancement time, and absence with rim-like enhancement are risk factors. The ROC curve for conventional US, CEUS, and conventional US combined with CEUS were 90.0%, 90.7%, 99.0%, respectively.ConclusionsOur results show that conventional US combined with CEUS had superior diagnostic performance for TI-RADS 3 and 4 thyroid micronodules compared with conventional US and CEUS alone.

Performance of Contrast-Enhanced Ultrasound in Thyroid Nodules: Review of Current State and Future Perspectives

“…A similar study was carried out by Xu et al in which 432 thyroid nodules were analyzed with CEUS and six suspicious features were pointed out as being specific in differentiating benign from malignant nodules: slow wash-in (p = 0.001), slow time to peak (p = 0.002), non-uniform enhancement (p = 0.023), irregular enhancement (p = 0.002), unclear enhancement boundary (p = 0.012) and no visible ring enhancement (p = 0.004) [34]. As in other studies, CEUS combined with TI-RADS showed better accuracy than any of the two alone, achieving a sensitivity of 85.66% and specificity of 83.33% [49,67].…”

The diagnostic value of ultrasonography in detection of different types of thyroid nodules

“…Using ultrasonography (US) in thyroid nodule detection has raised the nodule prevalence to reach 67%. Seven to fifteen percent of thyroid nodules are malignant [2,3].…”

Diagnostic value of multimodal ultrasound imaging in differentiating benign and malignant TI-RADS category 4 nodules

“…With the increased use of ultrasound (US) in medical practice, there has been an increase in the number of detected thyroid nodules, which are detected in about 20–67% of the general population [ 1 – 3 ]. It is, therefore, important to establish a standard method to accurately assess thyroid nodules.…”