Bae Unmin, Dighe Manjiri, Dubinsky Theodore, Minoshima Satoshi, Shamdasani Vijay, Kim Yongmin
Department of Electrical Engineering, University of Washington, Seattle, WA 98195-5061, USA.
J Ultrasound Med. 2007 Jun;26(6):797-805. doi: 10.7863/jum.2007.26.6.797.
The purpose of this study was to evaluate the feasibility of ultrasound thyroid elastography using carotid artery pulsation as the compression source and its potential for differential diagnosis of thyroid nodules.
Baseband sonographic data were acquired for 16 thyroid nodules from 12 patients. The natural pulsation of the carotid artery was used as the compression source, and thyroid strain was estimated offline. For quantitative assessment of thyroid tissue stiffness, a new metric called the thyroid stiffness index (TSI) was computed as the ratio of strain near the carotid artery (high-strain region) to that of a stiff region (low-strain region) inside a thyroid nodule. The stiffness information from elastography was correlated with histopathologic findings.
The TSI for papillary carcinoma (n = 9) was higher than the TSI for a benign nodular goiter (n = 6), indicating that papillary carcinoma is stiffer than a benign nodular goiter (P < .05). In 1 patient, we were able to distinguish a papillary carcinoma nodule and a benign nodular goiter located in the same thyroid lobe based on the stiffness information obtained from elastography. This suggests that elastography could be used for guiding fine-needle aspiration biopsy to a thyroid nodule with a high probability of cancer.
The results from this preliminary study indicate the feasibility of the pulsation-induced thyroid elastography. Ultrasound thyroid elastography using carotid artery pulsation appears to have the potential for noninvasively differentiating papillary carcinoma from benign nodular goiter. Future studies are needed to evaluate the efficacy of elastography in detecting thyroid cancer and guiding thyroid biopsies.
本研究旨在评估以颈动脉搏动作为压迫源的超声甲状腺弹性成像的可行性及其对甲状腺结节的鉴别诊断潜力。
采集了12例患者16个甲状腺结节的基带超声数据。以颈动脉的自然搏动作为压迫源，离线估计甲状腺应变。为了定量评估甲状腺组织硬度，计算了一种名为甲状腺硬度指数（TSI）的新指标，即甲状腺结节内颈动脉附近（高应变区域）的应变与硬区域（低应变区域）的应变之比。弹性成像的硬度信息与组织病理学结果相关。
乳头状癌（n = 9）的TSI高于良性结节性甲状腺肿（n = 6），表明乳头状癌比良性结节性甲状腺肿更硬（P <.05）。在1例患者中，我们能够根据弹性成像获得的硬度信息区分位于同一甲状腺叶的乳头状癌结节和良性结节性甲状腺肿。这表明弹性成像可用于指导对具有高癌变可能性的甲状腺结节进行细针穿刺活检。
这项初步研究的结果表明搏动诱导的甲状腺弹性成像的可行性。以颈动脉搏动为压迫源的超声甲状腺弹性成像似乎具有无创鉴别乳头状癌与良性结节性甲状腺肿的潜力。未来需要进行研究以评估弹性成像在检测甲状腺癌和指导甲状腺活检中的疗效。
