Value of Contrast-Enhanced Ultrasound in Mummified Thyroid Nodules

Sijie Chen; Kui Tang; Yi Gong; Fei Ye; Liyan Liao; Xiaodu Li; Qi Zhang; Yan Xu; Rongsen Zhang; Chengcheng Niu

doi:10.3389/fendo.2022.850698

Value of Contrast-Enhanced Ultrasound in Mummified Thyroid Nodules

Front Endocrinol (Lausanne). 2022 Mar 18:13:850698. doi: 10.3389/fendo.2022.850698. eCollection 2022.

Authors

Sijie Chen^{1

2}, Kui Tang^{1

2}, Yi Gong³, Fei Ye³, Liyan Liao⁴, Xiaodu Li^{1

2}, Qi Zhang^{1

2}, Yan Xu^{1

2}, Rongsen Zhang^{1

2}, Chengcheng Niu^{1

2}

Affiliations

¹ Department of Ultrasound Diagnosis, The Second Xiangya Hospital, Central South University, Changsha, China.
² Research Center of Ultrasonography, The Second Xiangya Hospital, Central South University, Changsha, China.
³ Department of Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
⁴ Department of Pathology, The Second Xiangya Hospital, Central South University, Changsha, China.

Abstract

Mummified thyroid nodules (MTNs) are rarely reported and are usually misdiagnosed as malignant nodules. This article first reviewed the contrast-enhanced ultrasound (CEUS) enhancement features of 218 MTNs and classified them into three (A, B, C) patterns. The A pattern MTNs show linear hypo-enhancement, the B pattern MTNs show heterogeneous hypo-enhancement, and the C pattern MTNs show no enhancement in thyroid nodules. The A and C pattern enhancements of MTNs demonstrated a high specificity compared with the enhancement of previously reported typical papillary thyroid carcinomas (PTCs). To further study the B pattern MTNs, 24 B pattern MTNs and 42 PTCs were enrolled in this study, and CEUS parameters for each nodule were evaluated. Univariate analysis indicated that compared with PTCs, the B pattern MTNs more frequently exhibited heterogeneous hypo-enhancement and clear margins after clearance (p <0.05). A multivariate analysis revealed that heterogeneous hypo-enhancement and clear margins after clearance were independent characteristics related to the B pattern MTNs for differentiating them from PTCs (p <0.05). Thus, preoperative CEUS may provide more important information for distinguishing MTNs from malignant thyroid nodules to avoid surgical excisions or unnecessary fine-needle aspiration (FNA).

Keywords: contrast-enhanced ultrasound (CEUS); fine-needle aspiration (FNA); mummified thyroid nodules (MTNs); papillary thyroid carcinomas (PTCs); thyroid ultrasonography.

MeSH terms

Biopsy, Fine-Needle
Diagnosis, Differential
Humans
Thyroid Neoplasms* / pathology
Thyroid Nodule* / pathology
Ultrasonography