Value Of Color Doppler Flow Imaging And Contrast-enhanced Ultrasonography Differential Diagnosis Of Benign Or Malignant Thyroid Nodules

Objective To investigate the value of Color Doppler flow imaging (CDFI) in the differential diagnosis of benign or malignant thyroid nodules.Methods Color Doppler flow imaging (CDFI) of 72 thyroid nodules were retrospectively analyzed. Applying Adler classification,the A/T, internal echo, acoustic halo, calcification, flow pattern and the features of blood vessels was observed.Results The malignant thyroid nodules showed unclear border(93.9%) , A/T≥1(75.8%), lower echo level(84.8%), echo attenuation(63.6%), cervical lymph node metastasis(27.3%) and microcalcification (54.5%). Most of the malignant thyroid nodules showed rich blood flow signals(81.8%), which was Adler 2 or Adler 3 pattern. The distribution of flow was abnormal and the massive rich blood flow or indiscriminate ramose vessels were appeared in the malignant thyroid nodules. Most of the benign thyroid nodules showed manipulus blood flow signals, which was Adler 0 or Adler 1 pattern. The blood flow showed sporadic dotted or ring courser and branching step by step. All above characteristics of the malignant thyroid nodules were different significantly comparing with the benign thyroid nodules(P<0.05).All the acoustic halo of the malignant thyroid nodules showed incomplete and uneven thickness, which CDFI was not observable. Nevertheless, All the acoustic halo of the benign thyroid nodules showed a complete narrow and uniform thickness ring, which CDFI showed ring blood flow at the periphery.Conclusion CDFI is valuable in the differential diagnosis of benign or malignant thyroid nodules and the combination with the two-dimensional sonogram will improve the diagnosis rate of thyroid papillary carcinoma. Objective To investigate the value of contrast-enhanced ultrasonography (CEUS) in the differential diagnosis of benign or malignant thyroid nodules.Methods Color Doppler flow imaging (CDFI) and contrast- enhanced ultrasonography perfusion of 72 thyroid nodules were retrospectively analyzed. The filling mode and intensity of both periphery and interior of the nodule by the time-intensity curve (TIC) was observed.The evaluated parameters were arrival time(AT), time to peak(TTP), peak intensity of the interior(IPI), slope(β) ,peak intensity of the periphery (PPI), interior intensity (II) at the PI time, the difference of PI and I (△I). Then the diagnostic cut-of points for thyroid benign or malignant thyroid nodules was calculated.Results Most of the malignant thyroid nodules were filled SonoVue pervasively (96.97%). and the majority showed high enhancement Most of the benign thyroid nodules showed early wash in of the periphery(79.49%), and the majority showed ring enhancement at periphery, slight or none enhancement in interior. The diagnostic cut-of points for thyroid benign or malignant thyroid nodules was 4.20(dB)using the ROC curve. The sensitivity was 85.2% and the false positive rate (FPR) was 15.1% .Conclusion CEUS is valuable in the differential diagnosis of benign or malignant thyroid nodules.