Contrast-enhanced ultrasound and BRAF mutation in diagnosis of extracapsular extension of papillary thyroid carcinoma / 中国医学影像技术

ABSTRACT

Objective: To investigate the value of contrast-enhanced ultrasound (CEUS) and BRAF mutation in pre-operative diagnosis of extracapsular extension in papillary thyroid carcinoma (PTC). Methods: A total of 129 PTC in 119 patients were enrolled, including 25 PTC with extracapsular extension (A group) and 104 PTC without extracapsular extension (B group). Both the range of contact between PTC and thyroid capsule and the presence of discontinued capsule in ultrasound (US) and CEUS, as well as BRAF mutation examination result were recorded. The diagnostic performance of the above features in diagnosis of extracapsular extension in PTC, and the overall diagnostic performance of their combination were calculated. Results: Significant differences were found in BRAF mutation, range of capsule contact and the presence of discontinued capsule between US and CEUS (all P<0.05). In different ranges of contact, the threshold of ≥25% demonstrated the highest diagnostic accuracy in both US and CEUS. CEUS had higher accuracy than US in diagnosis of extracapsular extension in PTC based on single ultrasonic feature as well as the combination of ultrasonic features and BRAF mutation. The accuracy of CEUS combined with BRAF was 88.37% (114/129). Conclusion: The characteristics of extracapsular extension in PTC include BRAF mutation, ≥25% range of contact between PTC and thyroid capsule and the presence of discontinued capsule in US and CEUS. CEUS has higher accuracy than US. Combination of BRAF mutation and CEUS has important clinical significance in preoperative diagnosis of PTC extracapsular extension.