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
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
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.