Objective:

To investigate the value of contrast-enhanced ultrasound (CEUS) in thyroid nodules which cannot be clearly diagnosed by fine-needle aspiration biopsy (FNAB).

Methods:

The CEUS data of 56 patients who could not be diagnosed

by FNAB in Jiading District Central Hospital

Shanghai University of Medicine and Health Sciences from Jan. 2016 to Feb. 2018 were retrospectively analyzed. The CEUS images of thyroid nodules were observed. The peak intensity (PI)

time to peak (TTP)

and area under curve (AUC) of nodules were obtained using time-intensity curve (TIC). The relative PI (△PI)

TTP (△TTP)

and AUC (△AUC) of the lesion to surrounding tissues were calculated. The receiver operating characteristic (ROC) curve was plotted by comparing with the surgical pathology. The comparison between CEUS and quantitative parameters for the diagnosis of nodules which FNAB could not clearly determined was performed.

Results:

A total of 62 nodules were found in 56 patients. Totally 30 cases of thyroid cancer were diagnosed by pathology. The malignant rate was 48.39%. The AUCs of enhancement pattern

△TTP

△PI and △AUC were 0.776 (95% CI: 0.652-0.872)

0.651 (95% CI: 0.519-0.767)

0.863 (95% CI: 0.751-0.937) and 0.799 (95% CI: 0.768-0.890). The diagnostic efficiency of △PI was the best. Its sensitivity was 83.33%

specificity was 78.12%

and accuracy was 80.62%.

Conclusion:

CEUS can provide additional evaluation criteria for nodules that cannot be clearly diagnosed by FNAB

and the diagnostic efficiency of △PI is the best.