Ultraschall Med 2013; 34 - WS_SL11_04
DOI: 10.1055/s-0033-1354870

Preoperative diagnosis of thyroid adenomas using linear high resolution contrast-enhanced ultrasound (CEUS): preliminary results

S Schleder 1, M Janke 1, M Hornung 2, M Georgieva 1, A Agha 2, EM Jung 1
  • 1University Hospital Regensburg, Department of Radiology, Regensburg, Germany
  • 2University Hospital Regensburg, Department of Surgery, Regensburg, Germany

Purpose: To evaluate the impact of high-resolution contrast-enhanced ultrasound (CEUS) and color coded and Power Doppler Sonography (CCDS/PD), in the preoperative recognition of thyroid adenomas.

Material and methods: A total of 40 patients underwent surgery for suspect thyroid nodules in 9 – 12/2011. CEUS with a linear probe (6 – 9 or 6 – 15 MHz, LOGIQ E9/GE) and CCDS/PD was performed in all patients preoperatively by an experienced operator 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.

Results: In 27 cases thyroid adenomas were diagnosed by histopathology. 4 cases showed complex cystic echo pattern. In the 23 remaining adenomas CEUS showed inhomogenous enhancement in 19 cases and another 13 adenomas proved early central wash-out with persisting peri-tumoral or rim enhancement.

In 12 cases early inhomogenous enhancement was combined with early central wash-out with persisting peri-tumoral or rim enhancement. 22 thyroid adenomas had strong hypervascularisation in CCDS/PD. 14 thyroid nodules (61%) had preoperatively been classified as adenomas correctly.

Conclusion: Dynamic evaluation of microcirculation by CEUS and CCDS/PD enables a more reliable preoperative characterization of thyroid adenomas.

Fig. 1: wash-out with persisting peri-tumoral enhancement