Abstract:

Objectives: To evaluate contrast-enhanced ultrasound (CEUS) for guiding fine-needle aspiration (FNA) of suspicious thyroid nodules to obtain sufficient biopsy specimens.
Methods: A total of 236 uncertain thyroid nodules detected in 228 patients from October 2016 to March 2017 were retrospectively reviewed and analyzed in this study. Overall, 117 patients underwent CEUS-guided FNA, and 111 patients underwent ultrasound (US)-guided FNA. The target for aspiration was only at the enhanced area in the CEUS group. In the US-guided group, aspiration was conducted within the nodule at various angles and areas. The final cytopathologic findings were reported using the Bethesda criteria. The inadequacy, indeterminacy, malignancy, and benignity rates of FNA specimens were compared between two groups.
Results: There were no significant differences in age, sex, or nodule size between the two groups. The inadequacy rate in the CEUS group was significantly lower than that in the US group (P = 0.008). Twenty-two benign nodules were diagnosed using CEUS-guided FNA, whereas seven were diagnosed using US-guided FNA (P = 0.006). The indeterminacy and malignancy rates were similar for both groups.
Conclusions: CEUS-guided FNA improves the diagnostic success rate and reduces uncertainty by facilitating accurate biopsy of suspected thyroid nodules with microcirculation perfusion imaging.

Key words: Thyroid; Neoplasm; Ultrasound; Contrast agent; Fine-needle aspiration