Application Value of Super-Resolution Ultrasound Imaging in the Diagnosis of American College of Radiology Thyroid Imaging Reporting and Data System Category 4 and 5 Thyroid Nodules.

Objective To investigate the value of super-resolution ultrasound (SRUS) imaging in the diagnosis of American College of Radiology Thyroid Imaging Reporting and Data System category 4 and 5 thyroid nodules diagnosed by routine ultrasound examination. Methods This study prospectively included the patients who were scheduled for ultrasound-guided aspiration biopsy due to suspicious thyroid nodules found on routine ultrasound.Contrast-enhanced ultrasound (CEUS) examination and SRUS analysis were performed to observe the enhancement characteristics of the nodules and conduct quantitative analysis.With pathological results as the gold standard,various quantitative parameters were compared between the benign and malignant groups. Results The benign group had higher peak intensity,microvascular ratios (VRs) during the peak and decay phases,mean density,mean blood flow,mean velocity,and perfusion index than the malignant group (all P<0.05).The area under the receiver operating characteristic (ROC) curve (AUC) for the diagnosis of thyroid cancer based on the peak intensity of CEUS and the VRs during the peak and decay phases of SRUS were 0.76,0.80,and 0.76,respectively.The combined diagnosis utilizing all three parameters yielded an AUC of 0.80,with accuracy,sensitivity,and specificity all being 80.0%. Conclusion SRUS can quantitatively assess the microvascular distribution and circulation status within nodules,addressing the limitations of current ultrasound techniques and CEUS and providing accurate assistance for clinical diagnosis and treatment.