Study On Conventional Ultrasound,VTI Elastography And Contrast-enhanced Ultrasound In The Diagnosis Of Atypical Thyroid Nodules

Objective :Our study aims to discuss the value of the conventional ultrasound,VTI elastography and contrast-enhanced ultrasound in diagnosing atypical thyroid nodules in practice.Methods :140 thyroid nodules in 128 patients were enrolled in this study.All of them were performed with both conventional ultrasound and VTI elastography.Sonographic appearances and VTI elastography level of the thyroid nodules were then documented,according to which,each nodule was be scored and a ROC curve was made after that.If the conventional ultrasound and VTI elastography came to a discordant diagnosis,contrast-enhanced ultrasound then should be performed and recorded.After treated with surgical removal,all the thyroid nodules were taken to pathological examination.With pathological diagnosis,they were divided into groups to analyze their sonographic appearances,VTI elastography level and contrast-enhanced performance in this way to discuss their value in diagnosing atypical thyroid nodules.Results :1.Among these 140 thyroid nodules in 128 patients,47 of them is benign and 93 malignant.2.There was no significance in the different calcification patterns in both benign and malignant nodules of thyroid.3.The VTI elastography level showed significant difference in both benign and malignant nodules of thyroid and 4was decided to be the optimal diagnosis cut-off score.4.The optimal cut-off score for the conventional ultrasound group was 5 and the combination group was 8.The sensitivity and specificity of the latter group was distinctly higher.5.The difference in VTI elastography level in nodules(diameter)<10mm and(diameter)≥10mm was obvious but when it came to the nodules <10mm VTI elastography was less sensitive.6.The mood of contrast perfusion,nodule enhancement and the regression speed in both benign and malignant nodules of thyroid were associated.The benign nodules were in this "iso-or hyper-enhanced and synchronously enhanced and regressed" pattern while the malignant ones "hypo-enhanced and slowly enhanced but fast regressed".Conclusion :1.4 is decided to be the optimal cut-off VTI elastography level for making diagnosis of thyroid nodules.2.Microcalcification in nodules is strongly associated with malignancy,but macrocalcification should not be completely ruled out malignancy.3.The optimal cut-off score for the conventional ultrasound group was 5 and the combination group was 8.4.VTI elastography appeared to be more sensitive to nodules ≥10mm but far less sensitive to the ones <10mm,of which false-negativity is high.5.The benign nodules were in this "iso-or hyper-enhanced and synchronously enhanced and regressed" pattern while the malignant ones "hypo-enhanced and slowly enhanced but fast regressed".