Thyroid nodules (TN) are highly prevalent, with diagnostic imaging detecting them in over 60% of the general population [1]. Approximately 10–15% of TN are malignant, and different histopathological subtypes exhibit significant variations in biological behavior, treatment management and prognosis. Therefore, accurate identification of benign / malignant and pathological subtypes of TN is crucial for treatment decision-making [2].

While ultrasonography (US) is the primary technique to assess the underlying thyroid parenchyma and the TN features, the diagnostic accuracy is limited by many factors, such as an inexperienced sonographer or inadequate technique could lead to a misleading representation of imaging features [3]. The morphology, density and enhancement features obtained from computed tomography (CT) have certain value in showing the relationship between nodules and surrounding structures and lymph node metastasis, however, it has some limits such as poor differential diagnosis ability and radiation injury [4].

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a technique that measure tissue microcirculation's vascularity and permeability through pharmacokinetics during the passage of contrast material, offering the potential to observe fine lesion hemodynamics and distinguishing tissue heterogeneity. It has been previously proposed for differentiate benign and malignant lesions and predict tumor aggressiveness [[5], [6], [7]].

Routine DCE-MRI examination of thyroid gland typically uses a head and neck combined coil and 3D-volumetric interpolated breath-hold examination (3D-VIBE) sequence, with image quality susceptible to breathing and swallowing. Compressed sensing volumetric interpolated breath-hold examination (CS-VIBE) sequences enables free-breathing image acquisition with high spatial and temporal resolution [8]. Moreover, the use of dedicated thyroid coil may produce higher image signal-to-noise ratio [9,10]. We infer that the combination of CS-VIBE sequences and dedicated thyroid coil could improve the quantitative analysis and determination of the fine structure and hemodynamics of the lesions, with promising clinical applications. However, to our knowledge, few studies have investigate on the application of DCE-MRI in TN, with small sample size and conflicting results [5,6,11,12]. And there are no reports of DCE-MRI based on CS-VIBE in thyroid imaging. Therefore, this study aimed to evaluate the clinical value of DCE-MRI based on CS-VIBE in the differential diagnosis of TN.