The Impact of Thyroid Sonoelastography in Preventing Irrational Needle Biopsies in Evaluation of Benign Thyroid Nodules
S Wahab, I Ahmad
Hong Kong J Radiol 2018;21:107-13
DOI: 10.12809/hkjr1816829
Objective: Ultrasound elastography involves combining the diagnostic advantages of high-frequency ultrasound examination and the accuracy of thyroid cancer diagnosis based on the nodule’s stiffness. This study aimed to evaluate the elastographic appearances of different types of thyroid gland nodules and to explore the real diagnostic value and clinical utility of thyroid ultrasound elastography with histopathological analysis as a
reference standard.
Methods: A total of 72 sonographically visible thyroid nodules were included and their elastographic appearance being classified into six classes. Results of strain or quasistatic elastography were compared with pathological results on fine-needle aspiration cytology/biopsy and statistical analysis performed with calculation of sensitivity, specificity, as well as positive and negative predictive values.
Results: A total of 42 nodules were diagnosed as malignant and 30 as benign on elastography. On histopathological analysis, 37 nodules were found malignant including 31 cases of papillary carcinoma and six of follicular carcinoma. The sensitivity, specificity, positive and negative predictive values of thyroid ultrasound elastography with histopathological diagnosis as reference standard were 97.29%, 82.85%, 85.71% and 96.67%, respectively.
Conclusion: Thyroid elastography can greatly reduce the rate of thyroid biopsies especially in benign-appearing lesion.
Author affiliation(s):
S Wahab, I Ahmad: Department of Radiodiagnosis, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India
中文摘要
甲狀腺超聲彈性成像在預防良性甲狀腺結節評估中的不合理針刺活檢
S Wahab, I Ahmad
目的：超聲彈性成像結合了高頻超聲檢查的診斷優勢和基於結節僵硬度的甲狀腺癌診斷的準確性。本研究旨在評估不同類型甲狀腺結節的彈性成像表現，並探討以組織病理學分析為參照標準的甲狀腺超聲彈性成像的實際診斷價值和臨床應用。
方法：研究中包括72個超聲可見的甲狀腺結節。結節的彈性成像外觀分為六種類型。將應變或準靜態彈性成像的結果與細針抽吸細胞學／活組織檢查的病理結果進行比較，並通過計算靈敏度、特異性，以及陽性和陰性預測值進行統計分析。
結果：彈性成像診斷42個結節為惡性，30個為良性。組織病理學分析發現37個結節為惡性，包括31例乳頭狀癌和6例濾泡狀癌。以組織病理學診斷為參考標準的甲狀腺超聲彈性成像的敏感性、特異性，以及陽性和陰性預測值分別為97.29%、82.85%、85.71%和96.67%。
結論：甲狀腺彈性成像可以大大降低甲狀腺活檢，尤其是良性病變的比率。