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Published on: April 21, 2023
Value of CEUS features in diagnosing thyroid nodules with halo sign on B-mode ultrasound
Xue-Jun Chen1, Lin-Jin Huang1, Feng Mao2
1Department of Ultrasound, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, 361015, Fujian Province, China.
Insights
Contrast-enhanced ultrasound (CEUS) features like enhanced intensity and high-enhancing rings can help differentiate benign from malignant thyroid nodules with a halo sign. This aids in accurate diagnosis when B-mode ultrasound findings are unclear.
Area of Science:
- Radiology
- Oncology
- Endocrinology
Background:
- The diagnostic value of the halo sign in B-mode ultrasound for thyroid nodules remains debated.
- Contrast-enhanced ultrasound (CEUS) has not been fully evaluated for characterizing thyroid nodules exhibiting a halo sign.
Purpose of the Study:
- To investigate the utility of CEUS features in differentiating benign from malignant thyroid nodules presenting with a halo sign on B-mode ultrasound.
Main Methods:
- Seventy-four pathologically confirmed thyroid nodules (43 benign, 31 malignant) with a halo sign underwent pre-operative CEUS.
- CEUS features, including enhancement time, intensity, homogeneity, and presence of an enhancing ring, were analyzed and compared between benign and malignant groups.
Main Results:
- Malignant nodules showed significantly more hypo-enhancement compared to benign nodules.
- A high-enhancing ring was detected more frequently in benign nodules (p=0.001).
- For nodules >10 mm, the high-enhancing ring was the sole distinguishing feature between benign and malignant lesions.
Conclusions:
- CEUS-derived enhanced intensity and the presence of a high-enhancing ring are valuable indicators for the differential diagnosis of thyroid nodules with a halo sign.
- These CEUS features can improve diagnostic accuracy for thyroid nodules that present with a halo sign on B-mode ultrasound.
Background:
The results of halo sign in the differential diagnosis of thyroid nodules were conflicting, and the value of contrast-enhanced ultrasound (CEUS) in characterization of thyroid nodules with halo has not been fully evaluated. This study was therefore designed to investigate the value of contrast-enhanced ultrasound features in the differential diagnosis of thyroid nodules with halo sign on B-mode ultrasound.
Material And Methods:
Seventy-four consecutive thyroid nodules with halo sign on B-mode ultrasound were pathologically confirmed by surgery or fine needle aspiration, including 43 benign and 31 malignant lesions. All these lesions underwent pre-operative CEUS examination. The CEUS features, including enhanced time, enhanced intensity and homogeneity, and presence of enhancing ring, were compared between benign and malignant ones.
Results:
Enhanced intensity was significant different between benign and malignant lesions with halo. Hypo-enhancement was more frequently detected in malignant nodules than that in benign ones, compared with iso-enhancement and hyper-enhancement (p = 0.013, and = 0.014, respectively). Detection rate of high-enhancing ring was significantly higher in benign nodules than that in malignant group (p = 0.001). While in nodules > 10 mm, only high-enhancing ring was the distinguishing feature between benign and malignant nodules.
Conclusions:
Enhanced intensity and high-enhancing ring may be helpful in the differential diagnosis of thyroid nodules with halo sign on B-mode ultrasound.
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