Background: 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. Methods: 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. Results: 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. Conclusions: 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.
背景：超声检查是评估甲状腺结节的主要方法，但该方法单一特征预测恶性的准确性不高。因此，本文旨在评估对比增强超声（CEUS）在甲状腺结节鉴别诊断中的应用价值。方法：研究组包括188例成年患者（155名女性和33名男性），这些患者在细针穿刺活检后甲状腺结节被归类为Bethesda II–VI类，术前接受了CEUS检查。在CEUS检查中，静脉注射1.5 mL SonoVue造影剂，随后分析了15种定性CEUS增强模式。结果：组织病理学结果显示包括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，如低增强和异质性增强以及缓慢的流入期，而高增强、环形增强和缓慢的流出期则被评估为良性病变的预测因子。研究发现了两种B超和CEUS模式的显著组合，即低回声伴异质性增强以及边缘不光滑伴低或等增强。结论：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超超声特征的结合显著提高了该方法的实用性。
肿瘤(癌症)患者之家