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Ultrasound in Medicine and Biology


The value of contrast-enhanced ultrasonography (CEUS) in the diagnosis of malignant partial cystic thyroid nodules (PCTNs) remains unclear. Thus, in the present study, the data of patients with pathologically proven PCTNs who underwent CEUS in the Chinese PLA General Hospital from January 2016 to February 2019 were retrospectively reviewed, and the imaging characteristics of benign and malignant PCTNs were compared. A total of 177 PCTNs were enrolled in this study, including 58 (32.7%) malignant nodules and 119 (67.2%) benign nodules. Six characteristics significantly differed between malignant PCTNs and benign PCTNs in univariate comparison: position of the solid portion (χ2 = 17.937, p < 0.001), microcalcifications (χ2 = 81.382, p < 0.001), boundaries (χ2 = 45.486, p < 0.001), echogenicity (χ2 = 11.152, p = 0.004), intensity of enhancement (χ2 = 40.656, p < 0.001) and uniformity of enhancement (χ2 = 19.933, p < 0.001). Among these, microcalcifications, boundaries, position of the solid portion, and uniformity of enhancement were independent risk factors in the multivariate comparison. A logistic regression model for predicting benign and malignant PCTNs was established with a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 89.0% (95% confidence interval [CI]: 0.788–0.961), 91.0% (95% CI: 0.830–0.946), 81.0% (95% CI: 0.715–0.881), 95.0% (95% CI: 0.892–0.974) and 90.0% (95% CI: 0.844–0.938), respectively. The area under the receiver operating characteristic curve was 0.967 (95% CI: 0.944–0.990), which was significantly higher than that of conventional ultrasound only (0.747, 95% CI: 0.663–0.831, Z = 2.090, p = 0.0366). CEUS can be used in the diagnosis of PCTNs, and the four characteristics of malignant PCTNs proven by our study were microcalcifications, unclear boundaries, eccentric distributions of the solid parts and heterogeneous enhancement.

Authors: QingSong*†; XiaoqiTian*; ZiyuJiao*; LinYan*; YuLan*; YaqiongZhu*; YukunLuo*

⁎Department of Ultrasound, First Medical Center, General Hospital of Chinese PLA, Haidian District, Beijing, China;  †Department of Ultrasound, Seventh Medical Center, General Hospital of Chinese PLA, Dongcheng District, Beijing, China

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