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| Diagnostic value of contrast-enhanced ultrasound in the invasiveness of papillary thyroid microcarcinoma without lymph node metastasis |
| JIANG Xin-hui, CHEN Jie, WANG Mei-yu, ZHOU Da-wei, XIN Jun, ZHENG Li |
| Department of Ultrasound, Shanghai Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 201999, China |
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Abstract Objective: To explore the diagnostic value of contrast-enhanced ultrasound(CEUS) and two-dimensional ultrasound in the invasiveness of single papillary thyroid microcarcinoma(PTMC) without lymph node metastasis. Methods: A total of 92 patients with single PTMC but without lymph node metastasis confirmed by surgery pathology were recruited as subjects. They were divided into the invasive group(n=13) and non-invasive group(n=79). The differences of the characteristics in two-dimensional ultrasound and CEUS were compared between the two groups. The accuracy of ultrasound and CEUS in the diagnosis of single PTMC without lymph node metastasis was analyzed. The diagnostic efficacy of the combination of the two methods was explored. Results: In the ultrasound characteristics, the proportion of unclear boundary and the rupture of the thyroid capsule echo in the invasive group were higher than those in the non-invasive group(P<0.05). In the CEUS characteristics, the proportion of unclear boundary after enhancement, marginal high enhancement, and enhancement range morphological changes in the invasive group were higher than those in the non-invasive group(P<0.05). The sensitivity, specificity, and accuracy of ultrasound in the diagnosis of single PTMC without lymph node metastasis were 46.15%, 79.75%, and 75.00%, which were lower than CEUS(84.62%, 83.54%, and 83.70%). The combination of ultrasound and CEUS for the diagnosis of invasiveness of single PTMC without lymph node metastasis was the best(AUC=0.929). The best diagnostic point was 0.87. The sensitivity was 100%, and the specificity was 87.74%. The fitting equation was Logit(P)=-2.146+0.585×Two-dimensional ultrasound boundary unclear+2.796×thyroid capsule echo interruption+0.659×enhanced boundary unclear+3.521×enhanced edge height enhancement+5.541×enhanced range morphological change. Conclusion: CEUS combined with two-dimensional ultrasound can better indicate the invasive growth and capsule invasion of single PTMC without lymph node metastasis, and has high application value in judging its invasive ability.
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Received: 17 October 2019
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2020, Vol. 31 
