---
title: "Thyroid Lymphatic Contrast-Enhanced Ultrasound (LCEUS) Improves Differentiation of Benign and Mali"
id: "pubmed-42660832"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42660832"
content_type: "clinical_feed_article"
specialty: "Oncology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42660832/"
doi: "10.3881/j.issn.1000-503X.17106"
published_at: "2026-08-30T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Thyroid Lymphatic Contrast-Enhanced Ultrasound (LCEUS) Improves Differentiation of Benign and Mali
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42660832
- **Specialty:** [Oncology](https://medichelpline.com/clinical-feed/oncology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42660832/)
- **DOI:** [10.3881/j.issn.1000-503X.17106](https://doi.org/10.3881%2Fj.issn.1000-503X.17106)
- **Published At:** 2026-08-30T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This prospective single-center study (Nov 2020–Jun 2024) evaluated **lymphatic contrast-enhanced ultrasound (LCEUS)** for differentiating benign and malignant thyroid nodules in patients scheduled for biopsy or surgery. - A total of 144 patients with one nodule each were included: 107 malignant and 37 benign by pathology (gold standard). - All patients underwent conventional ultrasound and **LCEUS** before intervention; enhancement patterns inside nodules, around nodules, and at adjacent thyroid capsule were recorded. - Inter-observer agreement for each LCEUS index was excellent (Kappa 0.84–0.93), supporting reproducibility of LCEUS features. - Malignant nodules more frequently demonstrated **non-enhancement** (88.79% vs 18.92%), post-contrast lesion area enlargement (60.75% vs 18.92%), and irregular ring-shaped peripheral enhancement (49.53% vs 10.81%); all differences were statistically significant (P < 0.001). - Diagnostic performance of LCEUS for malignancy: sensitivity 97.20%, specificity 75.68%, and accuracy 91.67%. - Area under the ROC curve (AUC) for LCEUS was 0.864, significantly higher than that of conventional ultrasound (AUC 0.761; P < 0.001), indicating superior overall diagnostic ability. - Authors conclude that by revealing lymphatic perfusion characteristics within and around nodules, **LCEUS** offers excellent efficacy for benign–malignant differentiation and outperforms conventional ultrasound in specificity and overall diagnostic capability. - Details such as exact contrast agent, injection protocol, adverse events, and operator training were not reported in the abstract available from the source.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Chinese PLA Medical School，Beijing 100853，China. * 2 Department of Ultrasound，the First Medical Center，Chinese PLA General Hospital，Beijing 100853，China. * PMID: **42660832** * DOI: [ 10.3881/j.issn.1000-503X.17106 ](https://doi.org/10.3881/j.issn.1000-503x.17106) Item in Clipboard # Value of Thyroid Lymphatic Contrast-Enhanced Ultrasound in the Differential Diagnosis of Benign and Malignant Thyroid Nodules：A Prospective Single-Center Study Lei Cai et al. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2026. Show details Display options Display options Format Abstract PubMed PMID Zhongguo Yi Xue Ke Xue Yuan Xue Bao Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Zhongguo+Yi+Xue+Ke+Xue+Yuan+Xue+Bao%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Zhongguo+Yi+Xue+Ke+Xue+Yuan+Xue+Bao%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42660832/) . 2026 Aug 30;48(4):637-643. doi: 10.3881/j.issn.1000-503X.17106. ### Authors [Lei Cai](https://pubmed.ncbi.nlm.nih.gov/?term=Cai+L&cauthor_id=42660832)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42660832/#short-view-affiliation-1 "Chinese PLA Medical School，Beijing 100853，China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42660832/#short-view-affiliation-2 "Department of Ultrasound，the First Medical Center，Chinese PLA General Hospital，Beijing 100853，China."), [Tao-Hua Gou](https://pubmed.ncbi.nlm.nih.gov/?term=Gou+TH&cauthor_id=42660832)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42660832/#short-view-affiliation-1 "Chinese PLA Medical School，Beijing 100853，China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42660832/#short-view-affiliation-2 "Department of Ultrasound，the First Medical Center，Chinese PLA General Hospital，Beijing 100853，China."), [Yan Zhang](https://pubmed.ncbi.nlm.nih.gov/?term=Zhang+Y&cauthor_id=42660832)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42660832/#short-view-affiliation-1 "Chinese PLA Medical School，Beijing 100853，China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42660832/#short-view-affiliation-2 "Department of Ultrasound，the First Medical Center，Chinese PLA General Hospital，Beijing 100853，China.") ### Affiliations * 1 Chinese PLA Medical School，Beijing 100853，China. * 2 Department of Ultrasound，the First Medical Center，Chinese PLA General Hospital，Beijing 100853，China. * PMID: **42660832** * DOI: [ 10.3881/j.issn.1000-503X.17106 ](https://doi.org/10.3881/j.issn.1000-503x.17106) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract in [ English, ](https://pubmed.ncbi.nlm.nih.gov/42660832/#eng-abstract) [ Chinese ](https://pubmed.ncbi.nlm.nih.gov/42660832/#zho-abstract) Objective To explore the value of thyroid lymphatic contrast-enhanced ultrasound （LCEUS） in the differential diagnosis of benign and malignant thyroid nodules. Methods Patients who were suspected of having thyroid cancer by ultrasound and were planned to undergo puncture biopsy or surgery from November 2020 to June 2024 were prospectively enrolled.All the patients underwent conventional ultrasound and LCEUS before surgery.The enhancement characteristics within the nodules，around the nodules，and in the adjacent thyroid capsule were observed and recorded.With the pathological results as the gold standard，the above characteristics were compared between the benign and malignant groups. Results A total of 144 （37 benign and 107 malignant） nodules in 144 patients were finally included.The inter-observer consistency of each LCEUS index was excellent （Kappa value：0.84-0.93）.Compared with benign nodules，malignant nodules were more likely to show non-enhancement （88.79% _vs._ 18.92%， _P_ <0.001），an enlarged lesion area after contrast injection （60.75% _vs._ 18.92%， _P_ <0.001），and irregular ring-shaped enhancement （49.53% _vs._ 10.81%， _P_ <0.001）.The sensitivity，specificity，and accuracy of LCEUS in diagnosing malignant nodules were 97.20%，75.68%，and 91.67% respectively.The area under the receiver operating characteristic curve was 0.864，higher than that （0.761） of conventional ultrasound （ _P_ <0.001）. Conclusions By revealing the lymphatic perfusion characteristics inside and around the nodules，LCEUS shows excellent efficacy in the differential diagnosis of benign and malignant thyroid nodules.LCEUS exhibits significantly better specificity and overall diagnostic ability than conventional ultrasound，demonstrating important clinical application value. 目的 探讨经甲状腺淋巴超声造影（LCEUS）在甲状腺结节良、恶性鉴别诊断中的价值。方法 前瞻性纳入2020年11月至2024年6月因超声发现可疑甲状腺癌拟行穿刺活检或手术的患者，术前均行常规超声、LCEUS检查。观察并记录结节内、周边及邻近甲状腺被膜的增强特征。以病理结果为金标准，比较上述特征在良、恶性组之间的差异。结果 最终纳入144例患者144个结节（良性37例、恶性107例），LCEUS各指标的观察者间一致性极好（Kappa值 0.84~0.93）。与良性相比，恶性结节多表现为无增强（88.79%比18.92%， _P_ <0.001）、造影后病变范围扩大（60.75%比18.92%， _P_ <0.001）及不规则边缘增强（49.53% 比 10.81%， _P_ <0.001）。LCEUS诊断恶性结节的灵敏度、特异度、准确度分别为97.20%、75.68%、91.67%，受试者工作特征曲线下面积为0.864，显著高于常规超声的0.761（ _P_ <0.001）。结论 LCEUS通过揭示结节内部及周边的淋巴灌注特征，在甲状腺结节良、恶性鉴别中表现出优异的诊断效能，其特异度和整体诊断能力均显著优于常规超声，具有重要的临床应用价值。. **Keywords:** contrast-enhanced ultrasound; lymphatic vessel; thyroid nodule; ultrasound. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ Utility of contrast-enhanced ultrasound for evaluation of thyroid nodules. ](https://pubmed.ncbi.nlm.nih.gov/20067379/) Zhang B, Jiang YX, Liu JB, Yang M, Dai Q, Zhu QL, Gao P.Zhang B, et al.Thyroid. 2010 Jan;20(1):51-7. doi: 10.1089/thy.2009.0045.Thyroid. 2010.PMID: 20067379 * [ [Role of Contrast-enhanced Ultrasound in Distinguishing between Benign and Malignant Thyroid Nodules with Calcification]. ](https://pubmed.ncbi.nlm.nih.gov/34980330/) Wang ZF, Shang J, Zhu Y, Liu B.Wang ZF, et al.Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2021 Dec 30;43(6):905-910. doi: 10.3881/j.issn.1000-503X.13845.Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2021.PMID: 34980330Chinese. * [ Clinical diagnostic value of contrast-enhanced ultrasound and TI-RADS classification for benign and malignant thyroid tumors: One comparative cohort study. ](https://pubmed.ncbi.nlm.nih.gov/30681562/) Xu Y, Qi X, Zhao X, Ren W, Ding W.Xu Y, et al.Medicine (Baltimore). 2019 Jan;98(4):e14051. doi: 10.1097/MD.0000000000014051.Medicine (Baltimore). 2019.PMID: 30681562Free PMC article.Clinical Trial. * [ Diagnostic Value of Contrast-Enhanced Ultrasound for Differentiating Benign and Malignant Thyroid nodules: A Systematic Review and Meta‑Analysis. ](https://pubmed.ncbi.nlm.nih.gov/40784818/) Xu R, He Y, Xie X, Chen G.Xu R, et al.Ultrasound Med Biol. 2025 Nov;51(11):1878-1887. doi: 10.1016/j.ultrasmedbio.2025.07.015. Epub 2025 Aug 9.Ultrasound Med Biol. 2025.PMID: 40784818 * [ Diagnostic value of combined ultrasound contrast and elastography for differentiating benign and malignant thyroid nodules: a meta-analysis. ](https://pubmed.ncbi.nlm.nih.gov/38824246/) Liu F, Wang Y, Xiong Y, Li X, Yao J, Ju H, Ren F, Zhang L, Wang H.Liu F, et al.Sci Rep. 2024 Jun 1;14(1):12605. doi: 10.1038/s41598-024-63420-1.Sci Rep. 2024.PMID: 38824246Free PMC article. 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