Preoperative diagnosis of thyroid adenomas using high resolution contrast-enhanced ultrasound (CEUS)

Issue title: Selected articles of the 32nd Annual Conference of the German Society for Clinical Hemorheology and Microcirculation, Dresden, Germany, 24 – 25 May, 2013

Article type: Research Article

Authors: Agha, A. | Jung, E.M. | Janke, M. | Hornung, M. | Georgieva, M. | Schlitt, H.J. | Schreyer, A.G. | Strosczcynski, C. | Schleder, S.

Affiliations: Department of Surgery, University Hospital Regensburg, Regensburg, Germany | Department of Radiology, University Hospital Regensburg, Regensburg, Germany

Note: [] A. Agha and E.M. Jung have contributed equally to this manuscript.

Note: [] A. Agha and E.M. Jung have contributed equally to this manuscript.

Note: [] Corresponding author: Dr. med. Stephan Schleder, University Hospital Regensburg, Germany, Department of Radiology, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany. E-mail: stephan.schleder@ukr.de

Abstract: To evaluate the impact of high-resolution contrast-enhanced ultrasound (CEUS), Color Coded and Power Doppler Sonography (CCDS/PD), in the preoperative recognition of thyroid adenomas. A total of 64 patients (36 female, median age 54 years) underwent surgery for thyroid adenoma. CEUS with linear multifrequency probes (6–9 or 6–15 MHz) and CCDS/PD was performed in all patients preoperatively by an experienced examiner and images were stored in PACS. Reading of the ultrasound images was performed in consensus by two experienced radiologists. Histopathology was achieved as standard of reference in all patients. Median diameter of the tumor lesions was 27 mm. 31 nodules were found on the left side. In B-Scan mode 13 (20%) adenomas showed complex cystic echo pattern and 44 (69%) had a complete and sharp hypoechoic edge. 43 (67%) thyroid adenomas had strong hypervascularization in CCDS/PD. In 61 (95%) adenomas early contrast enhancement was present in CEUS and 50 (78%) adenomas proved no wash-out or central wash-out with persisting edge enhancement. In 47 (73%) cases early contrast enhancement was combined with no washout or with central wash-out with persisting edge enhancement. 45 (70%) thyroid lesions had preoperatively been classified as benign lesions correctly. Dynamic evaluation of microcirculation by CEUS and CCDS/PD enables a more reliable preoperative characterization of thyroid adenomas.

Keywords: CEUS, power doppler, ultrasound, thyroid adenoma

DOI: 10.3233/CH-131777

Journal: Clinical Hemorheology and Microcirculation, vol. 55, no. 4, pp. 403-409, 2013