Real-time Elastography and Contrast-Enhanced Ultrasound for the Assessment of Thyroid Nodules
In: Experimental and clinical endocrinology & diabetes, Jg. 118 (2010), Heft 9, S. 602-609
academicJournal
- print, 25 ref
Zugriff:
Objective: Work-up of thyroid nodules remains challenging. Recent technologies enable determination of tissue elasticity and perfusion using ultrasound devices. The aim of the present study was to evaluate real-time elastography (RTE) and contrast-enhanced ultrasound with Sonovue (CEUS) for the differentiation of benign and malignant thyroid nodules. Materials and Methods: Inclusion criteria were: nodules ≥ 1 cm, non-functioning or hypo-functioning on radionuclide scanning, and cytological/histological assessment. All patients received conventional ultrasound, RTE and CEUS. RTE was classified as: Elasticity-Score (ES)1=soft, ES2=predominantly soft, ES3=predominantly hard, ES4=hard nodule. CEUS-video clips were digitally recorded and analyzed using time-intensity-curves within selected regions-of-interest. Results: Fifty-three nodules in 50 patients were available for analysis. Forty-six nodules were benign on cytology/histology, 6 nodules were papillary carcinoma and one nodule was a follicular carcinoma. Nodule margin irregularity was the ultrasound pattern most predictive of malignancy with sensitivity 57% (95% confidence interval: 18-90%) and specificity 85% (71-94% p<0.05). When using ES3&4 for the diagnosis of malignant nodules sensitivity and specificity were 86% (42-99.7%) and 87% (75-95%), respectively (p=0.0003). The only malignant nodule missed with RTE was a follicular carcinoma. Sensitivity for the diagnosis of papillary carcinoma therefore was 100%. No specific CEUS pattern could be identified to differentiate between benign and malignant nodules. Conclusions: RTE seems to be a useful tool in the work-up of thyroid nodules to exclude papillary thyroid cancer. However, follicular carcinoma remains a challenging problem. CEUS did not improve the characterization of thyroid nodules in this preliminary study.
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Real-time Elastography and Contrast-Enhanced Ultrasound for the Assessment of Thyroid Nodules
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Autor/in / Beteiligte Person: | FRIEDRICH-RUST, M ; SPERBER, A ; ZEUZEM, S ; BOJUNGA, J ; HOLZER, K ; DIENER, J ; GRÜNWALD, F ; BADENHOOP, K ; WEBER, S ; KRIENER, S ; HERRMANN, E ; BECHSTEIN, W. O |
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Zeitschrift: | Experimental and clinical endocrinology & diabetes, Jg. 118 (2010), Heft 9, S. 602-609 |
Veröffentlichung: | Stuttgart: Thieme, 2010 |
Medientyp: | academicJournal |
Umfang: | print, 25 ref |
ISSN: | 0947-7349 (print) |
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