Value Of Contrast-enhanced Ultrasound And Acoustic Radiation Force Impulse-imaging In Differential Diagnosis Of Benign And Malignant Thyroid Nodules

Objective: To assess the value of contrast-enhanced ultrasound(CEUS) and acoustic radiation force impulse-imaging(ARFI) in differential diagnosis of benign and malignant thyroid nodules.Methods: CEUS was performed in eighty-eight thyroid nodules. The patterns of CEUS were analyzed. Then the ARFI technique was performed. The values of shear wave velocity(SWV) of the nodules and the surrounding normal thyroid tissue were obtained. The area under the curve(AUC) and cut-off point were obtained by using a receiver operating characteristic(ROC) curve analysis. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic rate of each modality were assessed and compared using pathological diagnosis.Results: In 88 nodules, 29 nodules were malignant and 59 were benign. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic rate of CEUS were79.3%, 91.5%, 82.1%, 90% and 87.5%, respectively. With a cut-off value of 2.565m/s for SWV value, the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic rate for malignancy were 75.9%, 94.9%, 88.0%, 88.9% and 88.6%, respectively. AUC was 0.844. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic rate of CEUS combined with ARFI were 93.1%, 89.8%, 81.8%, 96.3% and 90.9%.Conclusions: Both CEUS and ARFI have some value in the differential diagnosis of benign and malignant thyroid nodules. The combination of two methods can improve the diagnostic rate.