Follicular Thyroid Neoplasmon Conventional and Contrast-enhanced Ultrasound

• Published in: Advanced ultrasound in diagnosis and therapy 2022-06, Vol.6 (2), p.48-57
• Main Authors: Xuehong, Diao, MD, Lin, Chen, MD, Bo, Yu, MS, Jiamei, Jin, MS, Jia, Zhan, MD, Yue, Chen, BS
• Format: Article
• Language: English
• Subjects: follicular thyroid cancers|follicular adenomas|contrast-enhanced ultrasound|ultrasonography
• ISSN: 2576-2516
• DOI: 10.37015/AUDT.2022.210026

Objective: The aim of this study was to identify features of follicular thyroid neoplasm by conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) based on morphological and pathological correlations and make diagnostic strategy for predicting malignancy. Methods: Conventional US and CEUS were performed in 21 follicular thyroid cancers (FTCs) and 35 follicular adenomas (FAs) that were pathologically approved. Sonographic features were retrospectively reviewed, and diagnostic performance were analyzed using pathology as reference standard. Results: The most useful character in diagnosis of FTC by conventional US was round shape (OR=6.6), followed by absent of halo sign (Odds ratio, OR = 4.79) and calcification (OR = 3.875). Among all CEUS morphological and blow flow findings, incomplete rim enhancement pattern (OR = 19.2) and the presence of perfusion defects (OR = 5.454) were the most effective features to discriminate between FTC and FA. Based on the five discriminatory parameters, a diagnostic criterion was established to assess the risk of FTC. The sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV) and accuracy for predicting malignancy were 81.0 %, 80 %, 70.8 %, 87.5 % and 80.4%, respectively. Conclusions: CEUS provided additional sonographic features which is helpful for predicting potentially malignancy of follicular thyroid neoplasm.