Value of Contrast-Enhanced Ultrasound in Partially Cystic Papillary Thyroid Carcinomas

Fang, Fengkai; Gong, Yi; Liao, Liyan; Ye, Fei; Zuo, Zhongkun; Zhang, Qi; Li, Xiaodu; Niu, Chengcheng

doi:10.3389/fendo.2021.783670

Cited by 9 publications

(11 citation statements)

References 21 publications

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“…Contrast-enhanced ultrasound (CEUS) could provide improved characterization of dynamic microvessel perfusion in the differential diagnosis of focal thyroid nodules compared with color Doppler US, which could help to differentiate malignant thyroid nodules from benign thyroid nodules (9,(11)(12)(13). However, MTNs with the same conventional US appearance may have different CEUS features according to our current study.…”

Section: Introductionmentioning

confidence: 73%

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Value of Contrast-Enhanced Ultrasound in Mummified Thyroid Nodules

et al. 2022

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Mummified thyroid nodules (MTNs) are rarely reported and are usually misdiagnosed as malignant nodules. This article first reviewed the contrast-enhanced ultrasound (CEUS) enhancement features of 218 MTNs and classified them into three (A, B, C) patterns. The A pattern MTNs show linear hypo-enhancement, the B pattern MTNs show heterogeneous hypo-enhancement, and the C pattern MTNs show no enhancement in thyroid nodules. The A and C pattern enhancements of MTNs demonstrated a high specificity compared with the enhancement of previously reported typical papillary thyroid carcinomas (PTCs). To further study the B pattern MTNs, 24 B pattern MTNs and 42 PTCs were enrolled in this study, and CEUS parameters for each nodule were evaluated. Univariate analysis indicated that compared with PTCs, the B pattern MTNs more frequently exhibited heterogeneous hypo-enhancement and clear margins after clearance (p <0.05). A multivariate analysis revealed that heterogeneous hypo-enhancement and clear margins after clearance were independent characteristics related to the B pattern MTNs for differentiating them from PTCs (p <0.05). Thus, preoperative CEUS may provide more important information for distinguishing MTNs from malignant thyroid nodules to avoid surgical excisions or unnecessary fine-needle aspiration (FNA).

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Section: Introductionmentioning

confidence: 73%

“…CEUS performed technology and the ultrasound contrast agents were the same as our previous studies (9,(11)(12)(13). The CEUS videos were acquired and time-intensity curves (TICs) of the thyroid within selected regions of interest (ROIs) were analyzed according to our previous study (11).…”

Section: Ceus and Analysismentioning

confidence: 99%

Value of Contrast-Enhanced Ultrasound in Mummified Thyroid Nodules

et al. 2022

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“…According to the analysis of the results of ultrasound images in this study, the solid component in some cystic nodules with eccentric sharp angle, edge sharp angle, non-smooth free edge, nodule hypoechoic, or microcalcification was associated with malignant PCTNs (P<0.01). A related report found that, compared with benign nodular goiters, PCTNs more frequently presented with calcification, hypoechogenicity of the solid part, hypoenhancement, heterogeneous enhancement, centrifugal perfusion, peak intensity index <1, time to peak index ≥1, and area under the curve index <1 on preoperative US and CEUS ( 11 ). A recent review included eight studies with a total of 2,004 PCTNs.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Differential Diagnosis of Benign and Malignant Partially Cystic Thyroid Nodules Based on Ultrasound Characterization With a TIRADS Grade-4a or Higher Nodules

Wang

Zhang

et al. 2022

Front. Endocrinol.

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Partially cystic thyroid nodules (PCTNs) are a kind of thyroid nodule with both solid and cystic components, and are usually misdiagnosed as benign nodules. The objective of this study was to determine the ultrasound (US) characterizations with a TIRADS Grade-4a or higher partially cystic thyroid nodules (PCTNs) which are associated with being malignant or benign. In this study, 133 PCTNs with a TIRADS Grade-4a or higher were enrolled; 83 were malignant and 50 were benign. TI-RADS classification can detect malignant PCTNs, and its sensitivity, specificity, positive predictive value, negative predictive value, and accuracy are 39.8%, 96.0%, 94.3%, 49.0%, and 60.9%, respectively. Univariate analyses revealed that nodule shape, margin, and structure were related to PCTNs’ being benign and malignant, among which nodules taller-than-wide, with an irregular shape, non-smooth margin, eccentric sharp angle, or edge sharp angle were significantly associated with malignancy while ovoid to round nodules, smooth margins, multiple separation, and eccentric obtuse angle structures were significantly associated with a benign nature. For the solid part of PCTNs, its free margin, echo, and calcification are related to benign and malignant PCTNs. Among them, the free margin of the solid part is non-smooth, hypoechoic, and microcalcification, which are related to malignant PCTNs, while the free margin of the solid part is smooth, isoechoic, macrocalcification, non-calcification and are related to benign PCTNs. Calcification of solid part and free margin are important factors for predicting malignant PCTNs. In addition, nodules’ composition, blood flow signal, and other factors had nothing to do with PCTNs’ being benign or malignant. In the multivariate Logistic regression analysis, solid part calcification (OR: 17.28; 95%CI: 5.14~58.08) and free margin (OR: 3.18; 95%CI: 1.01~10.00) were revealed to be the strongest independent predictors for malignancy (P<0.05). Our study indicated that understanding the ultrasound characteristics of malignant PCTNs, to avoid misdiagnosed PCTNs patients, is important to make a precise diagnosis and prognosis of PCTNs.

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“…Some malignant nodules tend to have uniform high enhancement, which may be due to the small infiltration area of cancer cells and most of the nodules are benign tissues. 51 Therefore, there are also errors in the evaluation of nodules by CEU.…”

Section: Contrast Enhanced Ultrasoundmentioning

confidence: 99%

“…Some nodules with benign pathology show uneven enhancement, which may be related to the repeated hyperplasia and degenerative changes of the lesion. Some malignant nodules tend to have uniform high enhancement, which may be due to the small infiltration area of cancer cells and most of the nodules are benign tissues 51 . Therefore, there are also errors in the evaluation of nodules by CEU.…”

Section: Contrast Enhanced Ultrasoundmentioning

confidence: 99%

Multimodal ultrasound imaging: A method to improve the accuracy of diagnosing thyroid TI‐RADS 4 nodules

Han

Huang

Wang

et al. 2022

J of Clinical Ultrasound

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Thyroid nodule is a common and frequently occurring disease in the neck in recent years, and ultrasound has become the preferred imaging diagnosis method for thyroid nodule due to its advantages of noninvasive, nonradiation, real‐time, and repeatable. The thyroid imaging, reporting and data system (TI‐RADS) classification standard scores suspicious nodules that are difficult to determine benign and malignant as grade 4, and further pathological puncture is recommended clinically, which may lead to a large number of unnecessary biopsies and operations. Including conventional ultrasound, ACR TI‐RADS, shear wave elastography, super microvascular imaging, contrast enhanced ultrasound, “firefly,” artificial intelligence, and multimodal ultrasound imaging used in combination. In order to identify the most clinically significant malignant tumors when reducing invasive operations. This article reviews the application and research progress of multimodal ultrasound imaging in the diagnosis of TI‐RADS 4 thyroid nodules.

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Value of Contrast-Enhanced Ultrasound in Partially Cystic Papillary Thyroid Carcinomas

Cited by 9 publications

References 21 publications

Value of Contrast-Enhanced Ultrasound in Mummified Thyroid Nodules

Value of Contrast-Enhanced Ultrasound in Mummified Thyroid Nodules

Analysis of Differential Diagnosis of Benign and Malignant Partially Cystic Thyroid Nodules Based on Ultrasound Characterization With a TIRADS Grade-4a or Higher Nodules

Multimodal ultrasound imaging: A method to improve the accuracy of diagnosing thyroid TI‐RADS 4 nodules

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