Department of Ultrasound, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, 361015, Fujian Province, China.
Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, 200030, China.
BMC Med Imaging. 2023 Jan 21;23(1):11. doi: 10.1186/s12880-023-00966-y.
The results of halo sign in the differential diagnosis of thyroid nodules were conflicting, and the value of contrast-enhanced ultrasound (CEUS) in characterization of thyroid nodules with halo has not been fully evaluated. This study was therefore designed to investigate the value of contrast-enhanced ultrasound features in the differential diagnosis of thyroid nodules with halo sign on B-mode ultrasound.
Seventy-four consecutive thyroid nodules with halo sign on B-mode ultrasound were pathologically confirmed by surgery or fine needle aspiration, including 43 benign and 31 malignant lesions. All these lesions underwent pre-operative CEUS examination. The CEUS features, including enhanced time, enhanced intensity and homogeneity, and presence of enhancing ring, were compared between benign and malignant ones.
Enhanced intensity was significant different between benign and malignant lesions with halo. Hypo-enhancement was more frequently detected in malignant nodules than that in benign ones, compared with iso-enhancement and hyper-enhancement (p = 0.013, and = 0.014, respectively). Detection rate of high-enhancing ring was significantly higher in benign nodules than that in malignant group (p = 0.001). While in nodules > 10 mm, only high-enhancing ring was the distinguishing feature between benign and malignant nodules.
Enhanced intensity and high-enhancing ring may be helpful in the differential diagnosis of thyroid nodules with halo sign on B-mode ultrasound.
晕环征在甲状腺结节鉴别诊断中的结果存在争议,超声造影(CEUS)在评估具有晕环的甲状腺结节特征方面的价值尚未得到充分评估。因此,本研究旨在探讨 CEUS 特征在 B 超晕环征甲状腺结节鉴别诊断中的价值。
经手术或细针抽吸活检病理证实的 74 个连续甲状腺结节 B 超晕环征,包括 43 个良性和 31 个恶性病变。所有病变均行术前 CEUS 检查。比较良恶性病变的 CEUS 特征,包括增强时间、增强强度和均匀性以及增强环的存在。
良性和恶性晕环征之间的增强强度差异有统计学意义。与等增强和高增强相比,恶性结节中更常出现低增强(p = 0.013 和 p = 0.014)。良性结节中高增强环的检出率明显高于恶性结节(p = 0.001)。而在直径>10 mm 的结节中,只有高增强环是鉴别良恶性结节的特征。
增强强度和高增强环有助于 B 超晕环征甲状腺结节的鉴别诊断。