Żyłka Agnieszka, Dobruch-Sobczak Katarzyna, Piotrzkowska-Wróblewska Hanna, Jędrzejczyk Maciej, Bakuła-Zalewska Elwira, Góralski Piotr, Gałczyński Jacek, Dedecjus Marek
Department of Endocrine Oncology and Nuclear Medicine, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland.
Radiology Department II, Maria Sklodowska-Curie National Research Institute of Oncology, 02-034 Warsaw, Poland.
Cancers (Basel). 2024 May 17;16(10):1911. doi: 10.3390/cancers16101911.
Ultrasonography is a primary method used in the evaluation of thyroid nodules, but no single feature of this method predicts malignancy with high accuracy. Therefore, this paper aims to assess the utility of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of thyroid nodules.
The study group comprised 188 adult patients (155 women and 33 men) who preoperatively underwent CEUS of a thyroid nodule classified as Bethesda categories II-VI after fine-needle aspiration biopsy. During the CEUS examination, 1.5 mL of SonoVue contrast was injected intravenously, after which 15 qualitative CEUS enhancement patterns were analysed.
The histopathologic results comprised 65 benign thyroid nodules and 123 thyroid carcinomas. The dominant malignant CEUS features, such as hypo- and heterogeneous enhancement and slow wash-in phase, were evaluated, whereas high enhancement, ring enhancement, and a slow wash-out phase were assessed as predictors of benign lesions. Two significant combinations of B-mode and CEUS patterns were noted, namely, hypoechogenicity with heterogeneous enhancement and non-smooth margins with hypo- or iso-enhancement.
The preliminary results indicate that CEUS is a useful tool in assessing the risk of malignancy of thyroid lesions. The combination of the qualitative enhancement parameters and B-mode sonographic features significantly increases the method's usefulness.
超声检查是评估甲状腺结节的主要方法，但该方法的单一特征均无法高度准确地预测恶性肿瘤。因此，本文旨在评估超声造影（CEUS）在甲状腺结节鉴别诊断中的效用。
研究组包括188例成年患者（155例女性和33例男性），这些患者在细针穿刺活检后，术前对分类为贝塞斯达II-VI类别的甲状腺结节进行了CEUS检查。在CEUS检查期间，静脉注射1.5 mL声诺维造影剂，然后分析15种定性CEUS增强模式。
组织病理学结果包括65个良性甲状腺结节和123个甲状腺癌。评估了主要的恶性CEUS特征，如低增强和不均匀增强以及缓慢的动脉期增强，而高增强、环状增强和缓慢的延迟期增强被评估为良性病变的预测指标。注意到B超模式和CEUS模式的两种重要组合，即低回声伴不均匀增强以及边缘不光滑伴低增强或等增强。
初步结果表明，CEUS是评估甲状腺病变恶性风险的有用工具。定性增强参数与B超特征的组合显著提高了该方法的实用性。
