Contrast Enhanced Ultrasonogrphy (CEUS) And Quantitative Analysis Differentiate Between Solid Malignant And Benign Thyroid Masses

Objective:To evaluate the diagnostic value of CEUS and quantitative analysis in differentiating between thyroid malignant solid masses and benign solid masses.Methods:40patients with solid thyroid mass were enrolled into this prospective study during January2012and June2012. A total of45thyroid solid masses were evaluated by CEUS, and the final pathology diagnosis was confirmed by core biopsy or thyroidectomy. To evaluate the role of enhancement patterns and quantative parameters in differentiating the solid maglinant and benign masses.Results:Enhancement patterns were classfied into five types (nonenhancement, early hypo enhancement, hypo enhancement, isoenhancement, hyper enhancement). Two maglinant masses had nonenhancement pattern, and6malignant masses had early hypo enhancement pattern, and14malignant and4benign masses had the hypo enhancement pattern, and5malignant and7benign masses had the isoenhancement pattern, and1malignant and6benign masses had the hyper enhancement pattern. There was a significant difference between maglinant and benign enhancement patterns (X2=12.184, P=0.016). Nonenhancement, early hypoenhancement and whole phase hypoenhancement pattern predict thyroid solid malignant masses with sensitivity of78.5%and specificity of76.5%. Among seven quantative parameters used to predict throid malignant mass, the relative maxmum intensity (IMAX%) of lesions had highest value in differentiating the malignant and benign masses with sensitivity of80.8%and specificity of82.6%, and area under receiver operating curve (AUC) of the IMAX%is0.878. RT (rising time), TTP (time to peak intensity), mTT (mean transit time) had almost non differentiation value with AUC of0.619,0.601,0.656separately. And mTTRatio (mTT of lesion/mTT of parametic area), RTRatio (RT of lesion/RT of parametic area), TTPRatio (TTP of lesion/TTP of parametic area) had less differentiation value with AUC of0.749,0.744,0.704comparing with IMAX%.Conclusion:Nonenhancement and early or whole phase hypoenhancement could be characteristic enhancement pattern of malignant thyroid solid mass, and IMAX%had good diagnostic value in differentiating malignant and benign masses among the quantative parameters.