Differential diagnosis value of ultrasonic elastography on benign and malignant small thyroid nodules with or without Hashimoto thyroiditis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHAO Haina ,  MA Buyun , LUO Honghao

Department of Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

MA Buyun, Email: ws_mby@126.com

Keywords：

thyroid nodule; Hashimoto thyroiditis; elastography

DOI：

10.7507/1007-9424.201604091

Video：

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Objective To compare differences of characteristics of ultrasonic elasticity imaging for benign and malignant small thyroid nodules with or without Hashimoto thyroiditis (HT). Methods The thyroid nodules with ≤1 cm size and the category 4A, 4B, 4C, and 5 of Thyroid Imaging Reporting and Data System (TI-RADS) were included into this study, and a further examination of real-time elastography was performed. The final diagnosis was relied on the pathological diagnosis. The elasticity score and strain ratio (SR) were recorded and compared between these two groups, respectively. Results Of the 424 nodules, 103 nodules were accompanied with HT (thyroid nodule with HT group), 321 nodules were not accompanied with HT (thyroid nodule without HT group). In the thyroid nodule with HT group, the area under the receiver operator characteristic (ROC) curve (AUCs) of the elasticity score and the SR was 0.685 and 0.676, respectively; the optimal cut offs of the elasticity score and the SR was 3 points and 2.45 respectively, their corresponding sensitivity, specificity, and accuracy was 75.7%, 57.6%, 68.0% and 75.7%, 60.6%, 67.6%, respectively. In the thyroid nodule without HT group, the AUCs of the elasticity score and the SR was 0.692 and 0.692, respectively; the optimal cut offs of the elasticity score and the SR was 4 points and 2.84, respectively; their corresponding sensitivity, specificity, and accuracy was 57.5%, 74.2%, 69.2% and 76.1%, 59.7%, 67.7%, respectively. Conclusions Elastography is helpful in differential diagnosis of benign and malignant small thyroid nodules. While, standards of elasticity score and SR value in differential diagnosis are different between benign and malignant small thyroid nodules with HT and without HT, elasticity score and SR ratio decrease in benign and malignant small thyroid nodules with HT.

Citation： ZHAO Haina, MA Buyun, LUO Honghao. Differential diagnosis value of ultrasonic elastography on benign and malignant small thyroid nodules with or without Hashimoto thyroiditis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(11): 1342-1346. doi: 10.7507/1007-9424.201604091 Copy

1.	Frates MC, Benson CB, Charboneau JW, et al. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement.Radiology, 2005, 237(3): 794-800.
2.	Harach HR, Franssila KO, Wasenius VM. Occult papillary carcinoma of the thyroid. A " normal” finding in Finland. A systematic autopsy study. Cancer, 1985, 56(3): 531-538.
3.	Camargo RY, Tomimori EK. Usefulness of ultrasound in the diagnosis and management of well-differentated thyroid carcinoma. Arq Bras Endecrinol Metabol, 2007, 51(5): 783-792.
4.	李強, 原韶玲, 徐恩偉, 等. 超聲彈性成像對橋本氏病甲狀腺纖維化程度評估的初步研究. 中華超聲影像學雜志, 2014, 23(2): 121-124.
5.	Kwak JY, Han KH, Yoon JH, et al. Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk. Radiology, 2011, 260(3): 892-899.
6.	Ueno E, Ito A. Diagnosis of breast cancer by elasticity imaging (EI). Eizo Joho Medical, 2004, 36(12): 1-6.
7.	郝軼, 柳莉莎. 超聲彈性成像技術及其臨床應用. 醫學綜述, 2010, 16(3): 453-455.
8.	Konofagou EE. Quo vadis elasticity imaging? Ultrasonics, 2004, 42(1-9): 331-336.
9.	Ning CP, Jiang SQ, Zhang T, et al. The value of strain ratio in differential diagnosis of thyroid solid nodules. Eur J Radiol, 2012, 81(2): 286-291.
10.	王海玲, 趙利輝, 張晟, 等. 超聲彈性成像在甲狀腺微小癌診斷中的價值. 中華超聲影像學雜志, 2013, 22(1): 88-90.
11.	Wang J, Li P, Sun L, et al. Diagnostic value of strain ratio measurement in differential diagnosis of thyroid nodules coexisted with Hashimoto thyroiditis. Int J Clin Exp Med, 2015, 8(4): 6420-6426.
12.	Dighe M, Luo S, Cuevas C, et al. Efficacy of thyroid ultrasound elastography in differential diagnosis of small thyroid nodules. Eur J Radiol, 2013, 82(6): e274-e280.
13.	于萍, 張萬蕾, 于蕾, 等. 超聲彈性成像在甲狀腺微小病變診斷中的價值. 中國超聲醫學雜志, 2014, 30(7): 584-587.
14.	張英霞, 武仁. 甲狀腺微小癌的常規超聲診斷及彈性成像定量參數分析的應用. 內蒙古醫科大學學報, 2014, 36(2): 133-137.
15.	何玉霜, 金亞, 馬步云, 等. 甲狀腺影像報告和數據系統分級結合超聲彈性成像對甲狀腺結節的診斷效能. 中國普外基礎與臨床雜志, 2014, 21(9): 1081-1086.
16.	Sherman SI. Thyroid carcinoma. Lancet, 2003, 361(9356): 501-511.
17.	Takashima S, Fukuda H, Nomura N, et al. Thyroid nodules: re-evaluation with ultrasound. J Clin Ultrasound, 1995, 23(3): 179-184.
18.	Rago T, Santini F, Scutari M, et al. Elastography: new developments in ultrasound for predicting malignancy in thyroid nodules. J Clin Endocrinol Metab, 2007, 92(8): 2917-2922.
19.	Cong SZ. Comparison analysis between conventional ultrasonography and ultrasound elastography of thyroid nodules. Eur J Radiol, 2012, 81(8): 1806-1811.
20.	Liang XN, Guo RJ, Li S, et al. Binary logistic regression analysis of solid thyroid nodules imaged by high-frequency ultrasonography, acoustic radiation force impulse, and contrast-enhanced ultrasonography. Eur Rev Med Pharmacol Sci, 2014, 18(23): 3601-3610.
21.	鄧偉, 張英霞. 超聲彈性應變率比值法評價橋本甲狀腺炎合并結節性質的應用價值. 中國臨床醫學影像雜志, 2014, 25(12): 890-892.
22.	俞清, 王文平, 李超倫, 等. 超聲彈性成像技術診斷甲狀腺結節的影響因素探討. 上海醫學影像, 2010, 19(3): 165-167.

1. Frates MC, Benson CB, Charboneau JW, et al. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement.Radiology, 2005, 237(3): 794-800.
2. Harach HR, Franssila KO, Wasenius VM. Occult papillary carcinoma of the thyroid. A " normal” finding in Finland. A systematic autopsy study. Cancer, 1985, 56(3): 531-538.
3. Camargo RY, Tomimori EK. Usefulness of ultrasound in the diagnosis and management of well-differentated thyroid carcinoma. Arq Bras Endecrinol Metabol, 2007, 51(5): 783-792.
4. 李強, 原韶玲, 徐恩偉, 等. 超聲彈性成像對橋本氏病甲狀腺纖維化程度評估的初步研究. 中華超聲影像學雜志, 2014, 23(2): 121-124.
5. Kwak JY, Han KH, Yoon JH, et al. Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk. Radiology, 2011, 260(3): 892-899.
6. Ueno E, Ito A. Diagnosis of breast cancer by elasticity imaging (EI). Eizo Joho Medical, 2004, 36(12): 1-6.
7. 郝軼, 柳莉莎. 超聲彈性成像技術及其臨床應用. 醫學綜述, 2010, 16(3): 453-455.
8. Konofagou EE. Quo vadis elasticity imaging? Ultrasonics, 2004, 42(1-9): 331-336.
9. Ning CP, Jiang SQ, Zhang T, et al. The value of strain ratio in differential diagnosis of thyroid solid nodules. Eur J Radiol, 2012, 81(2): 286-291.
10. 王海玲, 趙利輝, 張晟, 等. 超聲彈性成像在甲狀腺微小癌診斷中的價值. 中華超聲影像學雜志, 2013, 22(1): 88-90.
11. Wang J, Li P, Sun L, et al. Diagnostic value of strain ratio measurement in differential diagnosis of thyroid nodules coexisted with Hashimoto thyroiditis. Int J Clin Exp Med, 2015, 8(4): 6420-6426.
12. Dighe M, Luo S, Cuevas C, et al. Efficacy of thyroid ultrasound elastography in differential diagnosis of small thyroid nodules. Eur J Radiol, 2013, 82(6): e274-e280.
13. 于萍, 張萬蕾, 于蕾, 等. 超聲彈性成像在甲狀腺微小病變診斷中的價值. 中國超聲醫學雜志, 2014, 30(7): 584-587.
14. 張英霞, 武仁. 甲狀腺微小癌的常規超聲診斷及彈性成像定量參數分析的應用. 內蒙古醫科大學學報, 2014, 36(2): 133-137.
15. 何玉霜, 金亞, 馬步云, 等. 甲狀腺影像報告和數據系統分級結合超聲彈性成像對甲狀腺結節的診斷效能. 中國普外基礎與臨床雜志, 2014, 21(9): 1081-1086.
16. Sherman SI. Thyroid carcinoma. Lancet, 2003, 361(9356): 501-511.
17. Takashima S, Fukuda H, Nomura N, et al. Thyroid nodules: re-evaluation with ultrasound. J Clin Ultrasound, 1995, 23(3): 179-184.
18. Rago T, Santini F, Scutari M, et al. Elastography: new developments in ultrasound for predicting malignancy in thyroid nodules. J Clin Endocrinol Metab, 2007, 92(8): 2917-2922.
19. Cong SZ. Comparison analysis between conventional ultrasonography and ultrasound elastography of thyroid nodules. Eur J Radiol, 2012, 81(8): 1806-1811.
20. Liang XN, Guo RJ, Li S, et al. Binary logistic regression analysis of solid thyroid nodules imaged by high-frequency ultrasonography, acoustic radiation force impulse, and contrast-enhanced ultrasonography. Eur Rev Med Pharmacol Sci, 2014, 18(23): 3601-3610.
21. 鄧偉, 張英霞. 超聲彈性應變率比值法評價橋本甲狀腺炎合并結節性質的應用價值. 中國臨床醫學影像雜志, 2014, 25(12): 890-892.
22. 俞清, 王文平, 李超倫, 等. 超聲彈性成像技術診斷甲狀腺結節的影響因素探討. 上海醫學影像, 2010, 19(3): 165-167.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Differential diagnosis value of ultrasonic elastography on benign and malignant small thyroid nodules with or without Hashimoto thyroiditis

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