Author/Authors :
Wang ، Na Department of Ultrasound - Medical Imaging Center, Affiliated Hospital of Yangzhou University - Yangzhou University , Sun ، Hongguang Department of Ultrasound - Medical Imaging Center, Affiliated Hospital of Yangzhou University - Yangzhou University , Qi ، Tingyue Department of Ultrasound - Medical Imaging Center, Affiliated Hospital of Yangzhou University - Yangzhou University , Cao ، Haiyan Department of Ultrasound - Medical Imaging Center, Affiliated Hospital of Yangzhou University - Yangzhou University , Li ، Nianfen Department of Ultrasound - Medical Imaging Center, Affiliated Hospital of Yangzhou University - Yangzhou University , Zhu ، Linhai Department of Thyroid Surgery - Affiliated Hospital of Yangzhou University - Yangzhou University , Ding ، Yongling Department of Pathology - Affiliated Hospital of Yangzhou University - Yangzhou University
Abstract :
Background: Asymptomatic subacute thyroiditis (aSAT) without inflammatory features is often difficult to distinguish from papillary thyroid carcinoma (PTC), even with ultrasonography. Under certain circumstances, a fine-needle aspiration biopsy (FNAB) is performed, which is known to increase the patient’s physical pain. Objectives: To investigate the value of quantitative contrast-enhanced ultrasonography (CEUS) in discriminating aSAT from PTC nodules. Patients and Methods: A total of 30 aSAT and 23 PTC patients were systematically reviewed. Quantitative CEUS parameters, including the rise time (RT), time to peak (TTP), maximum intensity (IMAX), as well as their extension indicators (ΔRT and ΔTTP), were determined in various nodule areas (total, central, peripheral, and control regions of nodules). Chi-square test and independent-samples t-test were performed to compare significant differences between PTC and aSAT. A receiver operating characteristics (ROC) curve analysis was also performed to assess the diagnostic efficacy of each parameter, as well as diagnostic efficacy indices, including sensitivity and specificity, in discriminating aSAT from PTC nodules. Results: Compared to the PTC group, patients with aSAT had a longer ∆RT1 (RT of the control area − RT of the whole area; 0.12 ± 0.69 vs. -0.2 ± 0.57, P = 0.03) and ∆RT3 (RT of the control area − RT of the central area; 0.43 ± 0.72 vs. 0.04 ± 0.94, P = 0.049). Besides, compared to the PTC group, the aSAT group had a shorter RT in the total area (RT1: 4.05 ± 1.56 vs. 4.91 ± 2.09, P = 0.045); a shorter TTP in the total (TTP1: 4.91 ± 1.76 vs. 7.30 ± 3.92, P = 0.005), peripheral (TTP2: 5.06 ± 1.97 vs. 7.00 ± 3.48, P = 0.01), and central (TTP3: 4.90 ± 1.68 vs. 7.57 ± 4.41, P = 0.004) areas; and a lower IMAX in the peripheral area (IMAX2: 0.74 ± 0.36 vs. 1.09 ± 0.57, P = 0.009). Based on the ROC curve analysis, the area under the curve was significantly larger for TTP1 as compared to RT1 (P = 0.027). Conclusion: Conventional ultrasound and CEUS examinations were inadequate in distinguishing PTC from aSAT. Overall, a quantitative analysis may indicate more biological characteristics of nodules, which can be helpful in the differential diagnosis
Keywords :
Contrast , Enhanced Ultrasound , Papillary Thyroid Carcinoma , Quantitative Analysis , Subacute Thyroiditis
