Value of contrast-enhanced ultrasonography in the differential diagnosis of benign and malignant thyroid nodules under the background of Hashimoto's thyroiditis / 中华超声影像学杂志

ABSTRACT

Objective To evaluate the value of the differential diagnosis of benign and malignant thyroid nodules under the background of Hashimoto' s thyroiditis (HT) using contrast-enhanced ultrasonography (CEUS).Methods Ninety-three single thyroid nodules with HT confirmed by operations and pathology were given CEUS examination,and time-intensity curves were drawn by using TomTec analyzing software.The parameters as followsrise time (RT),time to peak (TTP),mean transit time (mTT) and maximum intensity(IMAX) were compared by independent-samples t test,and the diagnostic value of parameters were analyzed by receiver operating characteristic (ROC) curve.Results In 93nodules,there were 56 benign thyroid nodules,and 37 malignant thyroid nodules.(1) After injection of contrast media,the enhancement and wash-out in benign nodules were mostly the same with peripheral gland,as well as the enhance intensity.Malignant nodules presented lower enhancement,with later rise time and earlier wash-out compared to peripheral gland.(2) mTT was longer,while IMAX was higher in benign nodules than those in malignant nodules (P ＜0.05).But there were no significant differences in RT or TTP between the two groups.(3) The cut-off value in diagnosis of benign and malignant thyroid nodules with HT assessed by ROC curve were mTT 21.70 s,IMAX 86.41％.When mTT,IMAX,and combination of the two parameters were used for the diagnosis of malignant thyroid nodules with HT,the sensitivity were 86.5 ％,83.8 ％,97.3 ％ and the specificity were 69.6 ％,75.0 ％,48.2 ％,respectively.Conclusions CEUS is helpful to identify the benign and malignant thyroid nodules under the background of HT.