Contrast-Enhanced Ultrasonography for Differential Diagnosis of Benign and Malignant Thyroid Lesions: Single-Institutional Prospective Study of Qualitative and Quantitative CEUS Characteristics
Table 2
Detailed description of qualitative parameters of CEUS.
Qualitative parameters of the CEUS enhancement pattern
Description
Homogeneous
The entire lesion was homogeneously and diffusely enhanced at the time-of-peak intensity
Heterogeneous
The lesion was just partially or heterogeneously enhanced at the time-of-peak intensity
Ring enhancement
There was a rim-like enhancement around the lesion, which had a clear margin and could appear at the wash-in or wash-out phase. Once the peripheral rim appeared, the pattern would be the ring enhancement with no consideration of whether there were homogeneous or heterogeneous features
Absent
No enhancement: No microbubble echoes were detected within the lesion
Time-intensity curves (TIC) shape of the nodule
ā
Monophasic
Continuous gradual wash-out from the time of reaching peak intensity until the end of the second minute
Typical biphasic
Continuous gradual wash-out from the time of reaching peak intensity which is interrupted by a smaller second peak followed by further continuous wash-out until the end of the second minute
Atypical biphasic
The smaller peak during wash-in phase followed by a short period of wash-out and subsequent reaching of higher peak intensity followed by continuous gradual wash-out until the end of the second minute
Polyphasic
Polyphasic wash-out curve
Comparison of the TIC shape of the lesion and the surrounding tissue
ā
Identical
The same TIC shape in nodule and in surrounding tissue
Different
Different TIC shapes in nodule and in surrounding tissue
Definitions of enhancement patterns in Appendix A are in concordance with the publication of Zhang et al. (2010) to keep uniformity of established methodology in our follow-up research.