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The aim of this study was to find an accurate method for the detection of extracapsular extension (ECE) in papillary thyroid carcinoma (PTC). A total of 102 patients with 109 PTC nodules were retrospectively enrolled. Contrast-enhanced ultrasound (CEUS) characteristics were evaluated. The diagnostic efficacy of quantitative CEUS and tumor size was analyzed. The qualitative CEUS features did not differ significantly between the ECE and non-ECE groups ( P  > 0.05). All of the quantitative CEUS parameters with the exception of peak intensity and tumor size were found to differ significantly between the ECE and non-ECE groups ( P  < 0.05). Multivariate stepwise logistic regression analysis demonstrated that time from peak to one half (TPH), tumor size and wash-in slope (WIS) were the significantly different parameters between the ECE and non-ECE groups ( P  = 0.000,  P  = 0.005 and  P  = 0.030, respectively).The sensitivity and specificity in the diagnosis of ECE were: TPH, 75.4% (43/57) and 78.9% (41/52), respectively; WIS, 87.7% (50/57) and 42.3% (22/52), respectively; and tumor size, 71.9% (41/57) and 65.4% (34/52), respectively. Quantitative CEUS analysis and tumor size are essential for the prediction of ECE in PTC; in particular TPH has good diagnostic value in detecting ECE. Our study provides important insights into the prediction of ECE in PTC.

Utility of quantitative contrast-enhanced ultrasound for the prediction of extracapsular extension in papillary thyroid carcinoma