Prediction of the therapeutic effect of microwave ablation on TI-RADS 4a thyroid nodules using ultrasound elastogra-phy combined with contrast-enhanced ultrasound

FENG Huamei; WANG Chunpeng; BAI Lijie

doi:10.20258/j.cnki.1006-9011.2025.01.008

Abstract：Objective To explore the predictive value of ultrasound elastography(UE)combined with contrast-enhanced ul-trasound(CEUS)for the microwave ablation treatment of TI-RADS 4a thyroid nodules.Methods 78 patients with thyroid nod-ules who were treated in the hospital from March 2020 to February 2022 were selected.All patients underwent microwave abla-tion therapy.Prior to treatment,UE combined with CEUS examination was performed,and quantitative analysis results were re-corded.Patients were followed up for one year and divided into a significantly effective group(58 cases)and a non-significantly effective group(20 cases)based on treatment efficacy.The results of ultrasound examination were compared between the two groups,and the receiver operating characteristic(ROC)curve and decision curve were used to analyze the predictive value of UE combined with CEUS on the therapeutic effect.Results The elastic strain rate ratio(SR),contrast agent peak time(TTP),and peak intensity(PI)of the non-significantly effective group were higher than those of the significantly effective group(P<0.05).There was no significant difference in the passage time(MMT)and rise time(RT)between the two groups of contrast agents(P>0.05).After ablation,UE showed significant efficacy in 58 cases and non-significant efficacy in 20 cases.CEUS showed significant improvement in 58 cases,no significant enhancement was observed on CEUS,20 cases were not significantly effective,and nodules were shown slight enhancement.ROC curves were drawn to analyze the AUC values of SR,TTP,and PI for predicting the efficacy of microwave ablation therapy,which were 0.799,0.785,and 0.798,respectively.The AUC values for combined prediction were not significantly different from those for single indicators(Z=1.880,1.959,1.919,P>0.05).Deci-sion curve analysis was drawn,the combined prediction of SR,TTP,and PI can improve the net return rate of TI-RADS 4a thy-roid nodule microwave ablation treatment.Conclusion The quantitative indicators of UE and CEUS have certain predictive value for the microwave ablation treatment of TI-RADS 4a thyroid nodules,and the combination of the two examinations can im-prove the predictive value.