Specific Original Articles on Thyroid and Parathyroid Diseases
The value of hyperenhancement sign on ultrasound, CT and their combination in diagnosis of thyroid benign and malignant nodules
Zhijiang Han, Yanyan Shu, Zhikai Lei, Jun Lou, Jinwang Ding
Published 2017-02-25
Cite as Chin J Endocr Surg, 2017, 11(1): 15-19. DOI: 10.3760/cma.j.issn.1674-6090.2017.01.005
Abstract
ObjectiveTo investigate the diagnostic value of hyperenhancement sign on ultrasound, CT and their combination in diagnosis of thyroid benign and malignant nodules.
MethodsThe contrast-enhanced ultrasound and enhanced CT datas of 172 thyroid nodules in 144 cases confirmed by operation and pathology were retrospectively analyzed, including 97 benign nodules and 75 malignant nodules. According to the degree of enhancement, these nodules were divided into iso- or low-enhancement and hyperenhancement. The distributions of ultrasound hyperenhancement, CT hyperenhancement and both of them in thyroid benign and malignant nodules, adenomatoid lesions and nodular goiters were analyzed, followed by χ2 test for statistical analysis.
ResultsIn 172 thyroid nodules, the proportions of ultrasound hyperenhancement, CT hyperenhancement and both of them in thyroid benign and malignant nodules were 53.6% (52/97) and 20.0% (15/75) (χ2=20.090, P<0.05) , 34.0% (33/97) and 4.0% (3/75) (χ2=23.033, P<0.05) , 31.0% (30/97) and 0% (0/75) (χ2=28.096, P<0.05) , respectively. Their sensitivity and specificity of diagnosing benign nodules were 53.6% (52/97) and 80.0% (60/75) , 34.0% (33/97) and 96% (72/75) , 30.9% (30/97) and 100% (75/75) , respectively. The proportions of ultrasound hyperenhancement, CT hyperenhancement and both of them in adenomatoid lesions and nodular goiters were 96.9% (31/32) and 32.3% (21/65) (χ2=35.946, P<0.05) , 65.6% (21/32) and 18.5% (12/65) (χ2=21.250, P<0.05) , 65.6% (21/32) and 13.8% (9/65) (χ2=26.912, P<0.05) . Their sensitivity and specificity of diagnosing adenomatoid lesions were 96.9% (31/32) and 67.7% (44/65) , 65.6% (21/32) and 81.5% (53/65) , 65.6% (21/32) and 87.2% (56/65) .
ConclusionsUltrasound hyperenhancement, CT hyperenhancement for diagnosing thyroid benign nodules are of significant value. Especially for adenomatoid nodules, ultrasound hyperenhancement has a higher sensitivity, while CT hyperenhancement has a higher specificity. Their combination can further improve the diagnostic specificity, thus reducing the unnecessary surgical trauma.
Key words:
Thyroid nodule; Contrast-enhanced ultrasound; Tomography; X-ray computed
Contributor Information
Zhijiang Han
Department of Radiology, First People’s Hospital of Hangzhou, Hangzhou 310006, China
Yanyan Shu
Department of Radiology, Hangzhou Xiaoshan Area First People’s Hospital, Hangzhou 311200, China
Zhikai Lei
Department of Ultrasound, First People’s Hospital of Hangzhou, Hangzhou 310006, China
Jun Lou
Department of Ultrasound, Hangzhou Cancer Hospital, Hangzhou 310002, China
Jinwang Ding
Surgical Oncology, First People’s Hospital of Hangzhou, Hangzhou 310006, China
