Incremental diagnostic value of shear wave elastography combined with contrast-enhanced ultrasound in TI-RADS category 4a and 4b nodules

J Med Ultrason (2001). 2020 Jul;47(3):453-462. doi: 10.1007/s10396-020-01016-8. Epub 2020 Apr 18.

Abstract

Purpose: To evaluate the diagnostic value of shear wave elastography (SWE) combined with contrast-enhanced ultrasonography (CEUS) in diagnosing thyroid imaging reporting and data system (TI-RADS) category 4a and 4b nodules.

Methods: TI-RADS, SWE, and CEUS features of 71 thyroid nodules (23 benign, 48 malignant) confirmed by postoperative pathological results were retrospectively analyzed. The diagnostic efficiency of each single method and that of a combination of three methods were compared.

Results: The sensitivity and specificity in diagnosing thyroid nodules were 70.83% and 65.22% for TI-RADS, 68.75% and 91.30% for SWE, 77.08% and 78.26% for CEUS, and 91.67% and 95.65% for TI-RADS + SWE + CEUS, respectively. The area under the curve for TI-RADS, SWE, CEUS, and TI-RADS + SWE + CEUS in diagnosing thyroid nodules were 0.680, 0.839, 0.799, and 0.937, respectively. A significant difference was observed between a combination of the three methods and any of them alone (p < 0.05).

Conclusion: Combining SWE and CEUS improves the differential diagnosis of TI-RADS category 4a and 4b nodules.

Keywords: Contrast-enhanced ultrasound; Shear wave elastography; TI-RADS; Thyroid nodules.

MeSH terms

  • Adult
  • Aged
  • Contrast Media*
  • Diagnosis, Differential
  • Elasticity Imaging Techniques / methods
  • Female
  • Humans
  • Image Enhancement / methods*
  • Male
  • Middle Aged
  • Multimodal Imaging / methods
  • Radiology Information Systems
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity
  • Thyroid Gland / diagnostic imaging
  • Thyroid Gland / pathology
  • Thyroid Nodule / diagnostic imaging*
  • Thyroid Nodule / pathology*
  • Ultrasonography / methods*
  • Young Adult

Substances

  • Contrast Media