Contrast-Enhanced Ultrasound for Diagnosing Thyroid Nodules With Indeterminate Cytology: A Retrospective Study.

IF 3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM Clinical Endocrinology Pub Date : 2024-11-06 DOI:10.1111/cen.15160

Yingchun Liu, Hui Liu, Jia Zhan, Qiliang Chai, Jun Zhu, Shengnan Ding, Lin Chen

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Abstract

Background: A small number of thyroid nodules cannot be clearly diagnosed using ultrasound-guided fine needle aspiration biopsy. Contrast-enhanced ultrasound (CEUS) has high diagnostic performance for thyroid nodules. We explored the value of CEUS for diagnosing thyroid nodules with indeterminate cytology.

Methods: Between September 2019 and July 2022, 27,646 patients with thyroid nodule(s) underwent conventional ultrasound (CUS) in our hospital. From these patients, 597 nodules were subjected to CEUS and ultrasound-guided fine needle aspiration biopsy and 116 thyroid nodules with indeterminate cytology diagnose were enrolled in this study. The independent risk factors for predicting malignancy were determined using univariate and multivariate logistic regression analyses. Receiver operating characteristic (ROC) curves were drawn for CUS, CEUS, and CEUS combined with CUS. The area under the curve (AUC) was calculated and compared.

Results: Of the 116 thyroid nodules, 40 (34.5%) were benign and 76 (65.5%) were malignant. Univariate analysis showed that the shape, echogenicity, margin, microcalcification, enhancement intensity, enhancement homogeneity, wash in, and wash out were significantly different between benign and malignant thyroid nodules (all p < 0.05). Multivariate logistic regression analysis showed that taller-than-wide, irregular margin, microcalcification, hypo-enhancement, heterogeneity enhancement, synchronous/slower wash in, and synchronous/slower wash out were independent risk factors for malignancy (all p < 0.05). ROC curve analysis showed that the AUC of CUS and CEUS were 0.769 and 0.848, respectively. No significant difference was observed in the AUC between the two modalities (p > 0.05). However, the AUC (0.934) of the CUS combined with CEUS was significantly higher than that of CEUS or CUS alone (both p < 0.05).

Conclusions: CEUS is helpful in diagnosing thyroid nodules with indeterminate cytology. CUS combined with CEUS is highly valuable for predicting malignancy.

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对比增强超声诊断细胞学不确定的甲状腺结节：回顾性研究

背景：少数甲状腺结节无法通过超声引导下的细针穿刺活检得到明确诊断。对比增强超声（CEUS）对甲状腺结节的诊断率很高。我们探讨了CEUS对细胞学不确定的甲状腺结节的诊断价值：方法：2019 年 9 月至 2022 年 7 月期间，27646 名甲状腺结节患者在我院接受了常规超声检查（CUS）。在这些患者中，597 例结节患者接受了 CEUS 和超声引导下细针穿刺活检，116 例细胞学诊断不确定的甲状腺结节患者被纳入本研究。采用单变量和多变量逻辑回归分析确定了预测恶性肿瘤的独立风险因素。绘制了 CUS、CEUS 和 CEUS 结合 CUS 的接收者操作特征（ROC）曲线。计算并比较曲线下面积（AUC）：结果：在 116 个甲状腺结节中，40 个（34.5%）为良性，76 个（65.5%）为恶性。单变量分析显示，良性和恶性甲状腺结节的形状、回声性、边缘、微钙化、增强强度、增强均匀性、洗入和洗出均有显著差异（均为 P 0.05）。然而，CUS 联合 CEUS 的 AUC（0.934）明显高于 CEUS 或单独 CUS 的 AUC（均为 p 结论：CUS 联合 CEUS 有助于诊断甲状腺结节：CEUS有助于诊断细胞学不确定的甲状腺结节。CUS 联合 CEUS 对预测恶性程度有很高的价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Endocrinology 医学-内分泌学与代谢

CiteScore

6.40

自引率

3.10%

发文量

192

审稿时长

1 months

期刊介绍： Clinical Endocrinology publishes papers and reviews which focus on the clinical aspects of endocrinology, including the clinical application of molecular endocrinology. It does not publish papers relating directly to diabetes care and clinical management. It features reviews, original papers, commentaries, correspondence and Clinical Questions. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.