The Value Of Contrast-enhanced Patterns In Differential Diagnosis Of Benign And Malignant Thyroid Nodules

Objective: To study the value the enhancement patterns for the differential diagnosis of benign and malignant thyroid nodules.Method: Select 110 patients(126 nodules) with thyroid nodules in our hospital(2014.1-2015.12) to conduct regular conventional ultrasound detection and contrast-enhanced ultrasound detection. To observe and summarize the conventional ultrasonic features of thyroid nodules and contrast-enhanced ultrasound enhancement patterns, and contrast enhancement patterns can be divided into four kinds: homogeneous enhancement, uneven enhancement, annular enhancement and no enhancement. Use the homogeneous enhancement pattern and annular enhancement pattern to diagnose benign thyroid nodules. Use the uneven enhancement pattern and no enhancement pattern to diagnose malignant thyroid nodules. Observe the contrast-enhanced ultrasound enhancement patterns of solid nodules and cystic or solid nodules. Compared with the postoperative pathological diagnosis results, evaluate the diagnostic accuracy of contrast-enhanced ultrasound and regular conventional ultrasound.Results: Confirmed by postoperative or FNA pathological diagnosis, among 126 nodules there are benign nodules in 59, there are 53 nodular goiters and 6 thyroid adenoma; 67 malignant nodules, pathological types are all thyroid papillary carcinoma. Conventional solid nodules on the ultrasonic findings and extremely low echoes, irregular margins(can show the lobulated or tip shape), shape if taller than wide, vascularity, present micro-calcification to identify differences between benign and malignant thyroid nodules have statistical significance(P < 0.05). More benign nodules after CEUS perform annular enhancement pattern(45/59), compared with the malignant group have statistical significance(P < 0.05). With annular enhancement pattern, the sensitivity of diagnosis of benign thyroid nodules, specific degrees and accuracy were 76.27%, 98.51% and 88.10% respectively. Malignant nodules after CEUS much performance of the uneven enhancement pattern(55/67), compared with benign group have statistical significance(P < 0.05). With uneven enhancement pattern, the sensitivity of diagnosis of malignant thyroid nodules, specific and accurate rate were 82.09%, 89.83% and 85.71% respectively. Cystic or solid nodules or solid nodules with annular enhancement patterns in the diagnosis of benign nodules compared with malignant group have statistical significance(P < 0.05). With uneven enhancement patterns in the diagnosis of malignant nodules compared with benign group have statistical significance(P < 0.05). Compared with the pathological diagnosis, conventional ultrasound and CEUS results have statistical significance(P < 0.05).CEUS diagnostic accuracy rate is higher than conventional ultrasound(P < 0.05).Conclusions: Conventional ultrasound is the check method of choice for thyroid nodules, but for some nodules there are still some difficulties in the differential diagnosis of benign and malignancy. The sensitivity of ultrasound imaging to identify benign and malignant nodules, specific degrees and accuracy were higher than conventional ultrasound, its qualitative diagnosis ability than conventional ultrasound. Benign and malignant thyroid nodules after contrast-enhanced ultrasound enhancement patterns performance is different, for the differential diagnosis of benign and malignant thyroid nodule have clinical application value.