Citation: | SHAO Chunhui, WANG Juan, JIANG Jue, ZHOU Qi, LI Peiying, LUO Yongke. Value of strain elastography and shear wave elastography in the diagnosis of benign and malignant thyroid nodules[J]. Journal of Clinical Medicine in Practice, 2023, 27(19): 113-117. DOI: 10.7619/jcmp.20231977 |
To compare the value of strain elastography (SE) and shear-wave elastography (SWE) in the diagnosis of benign and malignant thyroid nodules.
A total of 109 patients with single solid thyroid nodules who were examined by ultrasound and confirmed by puncture biopsy or surgical pathology from March 2021 to March 2023 were selected as study subjects. All patients underwent SE and SWE examinations. Pathological results were taken as the "gold standard" for diagnosis, and the mean value of SE strain (SEmean), the ratio of the mean strain of surrounding normal thyroid tissue to the mean strain of thyroid nodule (SR), elastic mean value of Young's modulus of SWE (Emean) and ratio of the average elasticity of thyroid nodule to the average elasticity of surrounding normal thyroid tissue (ER). The value of the two elasticity techniques in differentiating benign and malignant thyroid nodule was compared, and the correlations of SEmean and SR with Emean and ER.
The pathologic examination of 109 patients with thyroid nodules confirmed that 69 cases(benign group) were benign and 40 cases (malignant group) were malignant. The maximum diameter of nodules in the malignant group was significantly smaller, and the proportion of patients with nodular aspect ratio>1, unclear boundary, solid hypoecho and lack of blood supply was higher than that in the benign group (P < 0.05). There were no significant differences in age, gender and the proportion of small calcification inside nodules between two groups (P>0.05). SR, Emean and ER in malignant group were higher than those in benign group (P < 0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve (AUC) of SEmean and SR were 0.902 and 0.884, which were higher than 0.795 of Emean and 0.806 of ER (P < 0.05). SEmean was negatively correlated with Emean and ER (r=-0.689 0, -0.634 9, P < 0.05), and SR was positively correlated with Emean and ER (r=0.537 2, 0.688 3, P < 0.05).
SE and SWE have certain clinical application value in differentiating benign and malignant thyroid nodules, but SE technique has a high diagnostic efficiency. The two techniques have shortcomings, and they can be complementary in practical application to improve the diagnosis efficiency of benign and malignant thyroid nodules.
[1] |
WANG H Y, MEHRAD M, ELY K A, et al. Incidence and malignancy rates of indeterminate pediatric thyroid nodules[J]. Cancer Cytopathol, 2019, 127(4): 231-239. doi: 10.1002/cncy.22104
|
[2] |
HU X D, LIU Y J, QIAN L X. Diagnostic potential of real-time elastography (RTE) and shear wave elastography (SWE) to differentiate benign and malignant thyroid nodules: a systematic review and meta-analysis[J]. Medicine (Baltimore), 2017, 96(43): e8282. doi: 10.1097/MD.0000000000008282
|
[3] |
林少坤, 曾志雄, 刘中华, 等. 人工智能超声辅助诊断系统联合超声造影对ACR TI-RADS 4类结节的诊断价值[J]. 临床超声医学杂志, 2023, 25(2): 142-144. https://www.cnki.com.cn/Article/CJFDTOTAL-LCCY202302012.htm
|
[4] |
CAO H Y, FAN Q, ZHUO S S, et al. The value of Chinese thyroid imaging report and data system combined with contrast-enhanced ultrasound scoring in differential diagnosis of benign and malignant thyroid nodules[J]. J Ultrasound Med, 2022, 41(7): 1753-1761. doi: 10.1002/jum.15858
|
[5] |
FRIEDRICH-RUST M, VORLAENDER C, DIETRICH C F, et al. Evaluation of strain elastography for differentiation of thyroid nodules: results of a prospective DEGUM multicenter study[J]. Ultraschall Med, 2016, 37(3): 262-270. doi: 10.1055/s-0042-104647
|
[6] |
王刚, 杨超, 李大强, 等. 高频超声检查甲状腺乳头状癌超声图像的特征分析[J]. 中国肿瘤临床与康复, 2015, 22(10): 1192-1193. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZK201510015.htm
|
[7] |
张亚南, 潘泉, 朱翔宇, 等. 应变弹性成像联合C-TIRADS诊断甲状腺结节性质的价值分析[J]. 中华肿瘤防治杂志, 2022, 29(24): 1741-1745. https://www.cnki.com.cn/Article/CJFDTOTAL-QLZL202224004.htm
|
[8] |
彭晓静, 李奥, 叶新华, 等. 应变式弹性成像与剪切波弹性成像技术鉴别诊断乳腺良恶性病灶的价值比较[J]. 中华医学超声杂志: 电子版, 2016, 13(12): 942-947. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHCD201612013.htm
|
[9] |
王慧, 周文斌, 孙重期. 应变式弹性成像联合超声造影在乳腺导管原位癌诊断中的应用价值[J]. 临床肿瘤学杂志, 2018, 23(12): 1123-1127. https://www.cnki.com.cn/Article/CJFDTOTAL-LCZL201812015.htm
|
[10] |
叶蕾, 王立平, 王心宇, 等. 实时剪切波弹性成像对乳腺小肿块的各向异性与良恶性的评估价值[J]. 放射学实践, 2019, 34(3): 337-341. https://www.cnki.com.cn/Article/CJFDTOTAL-FSXS201903027.htm
|
[11] |
付遵峰, 沈雯怡, 郭筱, 等. 剪切波弹性成像与微细血管成像在KwaK版本的TI-RADS分类中4类以上甲状腺结节的鉴别诊断研究[J]. 中国超声医学杂志, 2022, 38(5): 501-505. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCY202205006.htm
|
[12] |
祝青, 杨世艳, 辛超, 等. 甲状腺癌患者超声弹性成像参数应变率比值与癌细胞生长及血管新生的关系[J]. 中国超声医学杂志, 2019, 35(8): 676-679. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCY201908002.htm
|
[13] |
OKASHA H H, MANSOR M, SHERIBA N, et al. Role of elastography strain ratio and TIRADS score in predicting malignant thyroid nodule[J]. Arch Endocrinol Metab, 2021, 64(6): 735-742.
|
[14] |
STOIAN D, IVAN V, SPOREA I, et al. Advanced ultrasound application-impact on presurgical risk stratification of the thyroid nodules[J]. Ther Clin Risk Manag, 2020, 16: 21-30.
|
[15] |
何广敏, 李涛, 郑荣辉, 等. 超声应变弹性成像评分联合超微血流分级鉴别甲状腺结节良恶性的价值[J]. 实用医学杂志, 2020, 36(14): 1988-1991. https://www.cnki.com.cn/Article/CJFDTOTAL-SYYZ202014027.htm
|
[16] |
吕新华, 杨付红, 常亚歌. 超声剪切波弹性成像对甲状腺癌包膜侵犯、淋巴结转移的诊断价值及其与促甲状腺素水平的相关性[J]. 实用癌症杂志, 2023, 38(2): 316-319. https://www.cnki.com.cn/Article/CJFDTOTAL-SYAZ202302036.htm
|
[17] |
COSGROVE D, BARR R, BOJUNGA J, et al. WFUMB guidelines and recommendations on the clinical use of ultrasound elastography: part 4. thyroid[J]. Ultrasound Med Biol, 2017, 43(1): 4-26.
|