Value Of Contrast-enhanced Ultrasound In The Differential Diagnosis Of Thyroid Nodules

Objective:To investigate the perfusion and enhancement pattern of thyroid nodules by Contrast-enhanced ultrasound, with the quantificational analysis software of Contrast Dynamic, and to discuss the difference of contrast-enhanced ultrasound (CEUS)in the thyroid nodules.Materials and Methods:From September 2010 to March 2011,39 pathologic proven thyroid lesions were studied using conventional ultrasound and contrast-enhanced ultrasound according our study protocol, including 27 benign nodules and 12 malignant nodules. Benign nodules were hyperplasia nodules, malignant nodules were papillary carcinomas(one of them had only TIC analysis).The border, shape, echogenicity, microcalcification and blood flow of the nodules were investigated on conventional ultrasound. Comparison of above sonographic criteria were done between benign thyroid nodules and malignant nodules. Criteria that showed significant differences between benign nodules and malignant nodules were further evaluated for their differential diagnose value between benign and malignant nodules. Contrast-enhanced ultrasound also was conducted on above nodules, Enhanced patterns were studied and compared between benign and malignant thyroid nodules. Enhanced patterns include ring-enhancement,hetero-enhancement,hyper-enhancement,Point-like enhancement,absent enhancement, analysing the laws of the performance of nodules. Analyzed the time-intensity curve with Contrast Dynamic. The curve by fitting gama offered the permsion parameters:the peak of the signal intensity, the time-to-peak, the area under the curve, mean transit time.These data were compared with the histologic findings. Summarize the features post-perfusion between benign and malignant thyroid nodules.Results:(1) Results Statistically differences were revealed for lesion'S border microcalcifications between benign and malignant nodules(P<0.05), benign thyroid nodules demonstrated regular in border, Malignant thyroid nodules demonstrated irregular in border, microcalcificatiom appeared in 9 malignant nodules and only 2 benign nodules.(2) Enhancement pattern differences were revealed between benign and malignant nodules(P<0.05),19 ring-Enhancements appeared in 27 benign nodules,11 hyper-enhancements appeared in 11 malignant nodules.(3)In TIC curve analysis, the area under the curve in benign nodules was much than malignant nodules(P<0.05),Peak and AUC_in benign was much than thyroid tissue(P<0.05).Conclusions:Border and microcalcification on conventional ultrasound were helpful criteria for the discrimination of malignant form benign nodules. Contrast enhanced ultrasound patterns were different in benign and malignant thyroid nodules. ring-enhancement was more demonstrated in benign nodules,hyper-enhancement highly suggested malignant nodules. analysing thyroid nodules using time-intensity curve provide helpful information in distinguishing the nature of thyroid nodules.