To assess the diagnositic value of contrast enhanced ultrasound(CEUS) combined with shear wave elastography(SWE) in diagnosing thyroid nodules in category 3 and 4.

89 thyroid nodules in 86 patients which were classified as TI-RADS category 3 or 4 by a skilled doctor were detected by CEUS and SWE examination respectively and confirmed by surgical and pathological findings.The enhancement patterns were recorded as follows:enhancement time(contrasted with the normal thyroid),peak intensity,enhancement homogeneousness,post-enhancement margin,post-enhancement region,enhancement style(whether it was ring enhancement,whether it was centripetal enhancement).The...

29 benign nodules and 14 malignant nodules were in category 3 and 15 benign nodules and 31 malignant nodules were in category 4.The maximum diameter of the nodules was 2.30-28.50mm(9.09±5.01mm for average).The results of Logistic regression analysis for CEUS showed:the most effective variable were post-enhancement region,enhancement time and peak intensity(P<0.05).The sensitivity,specificity,accuracy,PPV,NPV and area under the curve(AUC)of it were 82.2%, 72.7% ,77.5%, 82.2%, 72.7% and...

The combination of contrast enhanced ultrasound and shear wave elastography is remarkably significant in differential diagnosis of TI-RADS category 3 and 4 nodules and worth clinical promotion and application which can also be added into TI-RADS category.

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