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

Objective:To investigate the value of the Color Doppler Flow Imaging for the differential diagnosis of benign and malignant thyroid nodules.Methods:The ultrasonic data of115patients (74benign lesions and41malignant lesions) of thyroid nodules confirmed by surgery and pathology were retrospectively analyzed, and then their sonogram characteristics including shape, the A/T, acoustic halo, internal echo, internal calcification and cystic formation, flow pattern and shape of blood vessels were summarized. All nodules were divided into two subgroups according to size (≤2cm in size and>2cm in size). Results:①Malignant thyroid nodules showed irregular shape, A/T≥1, unclear margin, uneven thick and incomplete wide acoustic halo, the lowest echo and micro-calcification. Comparing with benign thyroid nodules, above characteristics of malignant thyroid nodules were significantly different (P<0.001). However, the cystic formation of benign thyroid nodules were different comparing with malignant nodules (P<0.05).②In the investigation, malignant thyroid nodules mainly showed Adler2or Adler3pattern and primarily displayed perforating branches-like(Ⅲtype) or branches-like(Ⅳ type) or cluster-like(Ⅴ type), the flow pattern and shape of blood vessels of malignant thyroid nodules were significantly different comparing with benign thyroid nodules (P<0.001).③In nodules≤2cm in size, Adler0or Adler1pattern was observed in the majority of benign and malignant nodules, there was no difference among them (P>0.05). While in nodules>2cm in size, Adler0or Adler1pattern was more frequently observed in benign nodules, similarly Adler2or Adler3pattern was more frequently found in malignant nodules, there was significantly different comparing with benign nodules (P<0.001).Conclusion:Color Doppler Flow Imaging has great clinic value in the differential diagnosis of benign and malignant thyroid nodules. Objective:To investigate the enhancement patterns for the differential diagnosis of the benign and malignant thyroid nodules in contrast-enhanced ultrasound (CEUS).Methods:The Color Doppler flow characteristics and the hole process of contrast-enhanced ultrasonography of73thyroid nodules (43benign and30malignant) were retrospectively analyzed. The enhanced patterns, the changes of the size, blood vessel shape and border of all the nodules were mainly and carefully observed before and after contrast-enhanced ultrasound. All nodules were divided into two subgroups according to size (≤2cm in size and>2cm in size).Results:①The malignant thyroid nodules (86.67%) showed heterogeneous enhancement pattern, together with increased range, irregular vessel shape, non-smooth border after contrast-enhanced ultrasound. Heterogeneous enhancement pattern correlated highly with malignant nodules, the sensitivity was86.67%, the specificity was88.37%, the positive predictive value was83.87%and negative predictive value was90.48%. The benign thyroid nodules (81.4%) showed ring enhancement patterns, together with no change range and smooth border after contrast-enhanced ultrasound. Ring enhancement pattern correlated highly with benign nodules, the sensitivity was81.4%, the specificity was96.67%, the positive predictive value was97.22%and negative predictive value was78.38%. There was significantly difference in enhancement patterns between benign and malignant thyroid nodules (P<0.001).②In both≤2cm in size group and>2cm in size group, malignant nodules were mainly observed heterogeneous enhancement patterns, there was no significantly difference among the two groups (P>0.05);in addition, benign nodules were mainly observed ring enhancement patterns, there was no significantly difference among the two groups too(P>0,05).Conclusion:The enhancement pattern has important value to the differential diagnosis of benign and malignant thyroid nodules.