Literature DB >> 23396751

Ultrasound examination using contrast agent and elastosonography in the evaluation of single thyroid nodules: Preliminary results.

F S Ferrari1, A Megliola, A Scorzelli, E Guarino, F Pacini.   

Abstract

AIM: To evaluate the usefulness of ultrasound (US) using contrast agent and elastosonography in the characterization of thyroid nodules.
MATERIALS AND METHODS: From November 2006 to July 2007, 23 patients with single thyroid nodules underwent B-mode US and power Doppler, US examination using contrast agent, elastosonography and fine needle aspiration cytology (FNAC). Sixteen patients underwent thyroidectomy.
RESULTS: The 23 nodules included 14 benign and 9 malignant lesions. Analysis of time/intensity curves showed that wash-in (8.8 ± 1.3 vs 12.1 ± 2.6 s; p = 0.002, t-test) and peak enhancement (15.3 ± 4.6 vs 22.2 ± 3.9 s; p = 0.001, t-test) occurred significantly earlier in the malignant nodules than in the benign nodules. Wash-out was monophasic in 70% of benign nodules, but in none of the malignant nodules; polyphasic in 30% of benign nodules and in 100% of malignant nodules. Polyphasic wash-out showed a statistically significant association with malignancy (p = 0.0007, χ(2)). Polyphasic wash-out yielded a sensitivity of 100%, specificity of 71%, positive predictive value (PPV) of 69%, negative predictive value (NPV) of 100% and diagnostic accuracy of 83%. In 78% of the benign nodules (11/14) elastosonographic patterns was 1-2 (elevated elasticity); in 88% of the malignant nodules (8/9) elastosonographic patterns was 3-4 (reduced elasticity). Elastosonography yielded a sensitivity of 88%, specificity of 78%, PPV of 72%, NPV of 91% and diagnostic accuracy of 82%. Elastosonographic patterns 3-4 is associated with malignancy (p = 0.001, χ(2)).
CONCLUSION: US using contrast agent and elastosonography can be a useful diagnostic tool in the evaluation of single thyroid nodules, particularly when FNAC result is non-diagnostic or suggests a follicular lesion, and in nodules <1 cm.

Entities:  

Keywords:  Contrast agent; Elastosonography; Thyroid; Ultrasound

Year:  2008        PMID: 23396751      PMCID: PMC3553260          DOI: 10.1016/j.jus.2008.03.004

Source DB:  PubMed          Journal:  J Ultrasound        ISSN: 1876-7931


  24 in total

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