| Objective:To investigate the value of the combination use of conventional ultrasonography, real-time elastography (RTE) and contrast-enhanced ultrasonography (CEUS) in the diagnosis of thyroid cancer with size less than or equal to 10 mm.Methods:Of 68 patients, a total of 90 thyroid nodules (maximum diameter less than or equal to 10 mm) were evaluated by conventional ultrasound, RTE and CEUS, respectively. Based on pathology or fine-needle aspiration cytology results, the subject characteristic curves (ROCs) of various methods were performed and the area under the curves (AUCs) were compared to evaluate the diagnostic performance of different techniques.Result:Of 90 thyroid nodules,37 and 53 were malignant and benign nodules, respectively. The AUCs of conventional ultrasound, RTE, CEUS, conventional ultrasound combined with RTE, conventional ultrasound combined with CEUS and three methods combination were 0.661,0.620,0.726,0.679,0.757 and 0.817, respectively. The AUC of three methods combination was significantly higher than that of each other method (P<0.05). Additionally, the AUC of RTE was significantly lower than each other method (P<0.05). The accuracy, sensitivity and specificity of three methods combination in the diagnosis of malignant thyroid nodules were 78.9%, 97.3% and 66%, respectively. The accuracy and sensitivity of three methods combination were significant higher than that of conventional ultrasound and RTE (Both P<0.05). However, no significant difference of specificity was found between each two methods (P>0.05).Conclusion:The combination use of conventional ultrasound, RTE and CEUS can dramatically improve the differential diagnosis ability in small thyroid nodules with size less than or equal to 10 mm. RTE may not be used alone to identify these nodules. Additionally, conventional ultrasonography combined with one of RTE and CEUS at least is proposed in clinic. |
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