Value of Quantitative Contrast-Enhanced Ultrasonography in Distinguishing Asymptomatic Subacute Thyroiditis from Papillary Thyroid Carcinoma

IF 0.2 4区医学 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Iranian Journal of Radiology Pub Date : 2021-07-31 DOI:10.5812/IRANJRADIOL.107225

Na Wang, Hongguang Sun, Qi Tingyue, Haiyan Cao, Li Nianfen, Linhai Zhu, Yongling Ding

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引用次数: 0

Abstract

Background: Asymptomatic subacute thyroiditis (aSAT) without inflammatory features is often difficult to distinguish from papillary thyroid carcinoma (PTC), even with ultrasonography. Under certain circumstances, a fine-needle aspiration biopsy (FNAB) is performed, which is known to increase the patient’s physical pain. Objectives: To investigate the value of quantitative contrast-enhanced ultrasonography (CEUS) in discriminating aSAT from PTC nodules. Methods: A total of 30 aSAT and 23 PTC patients were systematically reviewed. Quantitative CEUS parameters, including the rise time (RT), time to peak (TTP), maximum intensity (IMAX), as well as their extension indicators (ΔRT and ΔTTP), were determined in various nodule areas (total, central, peripheral, and control regions of nodules). Chi-square test and independent-samples t-test were performed to compare significant differences between PTC and aSAT. A receiver operating characteristics (ROC) curve analysis was also performed to assess the diagnostic efficacy of each parameter, as well as diagnostic efficacy indices, including sensitivity and specificity, in discriminating aSAT from PTC nodules. Results: Compared to the PTC group, patients with aSAT had a longer ∆RT1 (RT of the control area − RT of the whole area; 0.12 ± 0.69 vs. -0.2 ± 0.57, P = 0.03) and ∆RT3 (RT of the control area − RT of the central area; 0.43 ± 0.72 vs. 0.04 ± 0.94, P = 0.049). Besides, compared to the PTC group, the aSAT group had a shorter RT in the total area (RT1: 4.05 ± 1.56 vs. 4.91 ± 2.09, P = 0.045); a shorter TTP in the total (TTP1: 4.91 ± 1.76 vs. 7.30 ± 3.92, P = 0.005), peripheral (TTP2: 5.06 ± 1.97 vs. 7.00 ± 3.48, P = 0.01), and central (TTP3: 4.90 ± 1.68 vs. 7.57 ± 4.41, P = 0.004) areas; and a lower IMAX in the peripheral area (IMAX2: 0.74 ± 0.36 vs. 1.09 ± 0.57, P = 0.009). Based on the ROC curve analysis, the area under the curve was significantly larger for TTP1 as compared to RT1 (P = 0.027). Conclusion: Conventional ultrasound and CEUS examinations were inadequate in distinguishing PTC from aSAT. Overall, a quantitative analysis may indicate more biological characteristics of nodules, which can be helpful in the differential diagnosis.

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定量超声造影在鉴别无症状亚急性甲状腺炎和乳头状甲状腺癌中的价值

背景：没有炎症特征的无症状亚急性甲状腺炎（aSAT）通常很难与甲状腺乳头状癌（PTC）区分开来，即使用超声检查也是如此。在某些情况下，进行细针抽吸活检（FNAB），这会增加患者的身体疼痛。目的：探讨定量超声造影（CEUS）在鉴别aSAT和PTC结节中的价值。方法：对30例aSAT和23例PTC患者进行系统回顾性分析。在不同的结节区域（结节的总区、中心区、外围区和对照区）测定了定量CEUS参数，包括上升时间（RT）、峰值时间（TTP）、最大强度（IMAX）及其扩展指标（ΔRT和ΔTTP）。卡方检验和独立样本t检验用于比较PTC和aSAT之间的显著差异。还进行了受试者操作特征（ROC）曲线分析，以评估每个参数的诊断功效，以及区分aSAT和PTC结节的诊断功效指数，包括敏感性和特异性。结果：与PTC组相比，aSAT患者的∆RT1（对照区RT−整个区域的RT；0.12±0.69 vs.-0.2±0.57，P=0.03）和∆RT3（对照区的RT−中心区的RT；0.43±0.72 vs.0.04±0.94，P=0.049）更长。此外，与PTC组比较，aSAT组的总面积RT较短（RT1:4.05±1.56 vs.4.91±2.09，P=0.045）；总面积（TTP1:4.91±1.76 vs.7.30±3.92，P=0.005）、外周面积（TTP2:5.06±1.97 vs.7.00±3.48，P=0.001）和中心面积（TTP3:4.90±1.68 vs.7.57±4.41，P=0.004）的TTP较短；外周区IMAX较低（IMAX2:0.74±0.36vs.1.09±0.57，P=0.009）。根据ROC曲线分析，TTP1的曲线下面积明显大于RT1（P=0.027）。结论：常规超声和CEUS检查不足以区分PTC和aSAT。总体而言，定量分析可能表明结节具有更多的生物学特征，这有助于鉴别诊断。

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来源期刊

Iranian Journal of Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

0.50

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： The Iranian Journal of Radiology is the official journal of Tehran University of Medical Sciences and the Iranian Society of Radiology. It is a scientific forum dedicated primarily to the topics relevant to radiology and allied sciences of the developing countries, which have been neglected or have received little attention in the Western medical literature. This journal particularly welcomes manuscripts which deal with radiology and imaging from geographic regions wherein problems regarding economic, social, ethnic and cultural parameters affecting prevalence and course of the illness are taken into consideration. The Iranian Journal of Radiology has been launched in order to interchange information in the field of radiology and other related scientific spheres. In accordance with the objective of developing the scientific ability of the radiological population and other related scientific fields, this journal publishes research articles, evidence-based review articles, and case reports focused on regional tropics. Iranian Journal of Radiology operates in agreement with the below principles in compliance with continuous quality improvement: 1-Increasing the satisfaction of the readers, authors, staff, and co-workers. 2-Improving the scientific content and appearance of the journal. 3-Advancing the scientific validity of the journal both nationally and internationally. Such basics are accomplished only by aggregative effort and reciprocity of the radiological population and related sciences, authorities, and staff of the journal.