Diagnostic value of contrast enhanced ultrasound combined with ultrasound-guided fine-needle aspiration in differentiating malignant and benign thyroid nodules / 中华超声影像学杂志

ABSTRACT

Objective To evaluate the diagnostic value of contrast enhanced ultrasound ( CEUS ) combined with ultrasound-guided fine-needle aspiration ( US-FNA) in differentiating malignant and benign thyroid nodules . Methods A retrospective review of preoperative CEUS and US-FNA data of 161 thyroid nodules confirmed by surgical pathology from 145 patients was performed . The CEUS enhancement patterns of whole phase hypo-enhancement ,uneven hypo-enhancement and early phase hypo-enhancement were taken as the diagnostic criteria for malignant thyroid nodules . According to the Bethesda System ,the grade≥ Ⅳ was taken as the cytologic criteria for diagnosis of malignant thyroid masses . The 161 thyroid nodules were divided into large nodules group( the longest diameter of thyroid nodules were higher than 1 .0 cm) and small nodules group ( the longest diameter of nodules were higher than 0 .5 cm but lower than 1 .0 cm) . The diagnostic value of CEUS ,US-FNA and the combination were evaluated respectively in the the two groups . Results In large nodules group ,the sensitivities of CEUS ,US-FNA and the combination were 88 .0% ,81 .3% ,94 .7% ,respectively ;their specificities were 88 .5% ,100% ,88 .5% ,respectively . There was no statistically difference in sensitivity between CEUS and US-FNA ( P ＝ 0 .301) ,the sensitivity of the combination was higher than US-FNA ( P ＝0 .004) . In small nodules group ,the sensitivities of CEUS ,US-FNA and the combination were 52 .4% ,78 .6% ,92 .9% ,respectively ;their specificities were 94 .4% ,100% , 94 .4% ,respectively . There was statistically difference in sensitivity between CEUS and US-FNA ( P ＜0 .05) ,the combination had the highest sensitivity ( P ＜ 0 .05).Conclusions For thyroid nodules whose longest diameter higher than 1 cm ,there is no statistically difference in sensitivity between CEUS and US-FNA .The combination had higher sensitivity than US-FNA .For thyroid nodules whose longest diameter higher than 0 .5 cm but lower than 1 .0 cm ,US-FNA provided higher sensitivity than CEUS ,the combination provided higher sensitivity than single CEUS or US-FNA .