Slapa Rafal Z, Piwowonski Antoni, Jakubowski Wieslaw S, Bierca Jacek, Szopinski Kazimierz T, Slowinska-Srzednicka Jadwiga, Migda Bartosz, Mlosek R Krzysztof
Department of Diagnostic Imaging, Second Faculty of Medicine, Medical University of Warsaw, ul. Kondratowicza 8, 03-242 Warsaw, Poland.
J Thyroid Res. 2012;2012:657147. doi: 10.1155/2012/657147. Epub 2012 May 17.
Although elastography can enhance the differential diagnosis of thyroid nodules, its diagnostic performance is not ideal at present. Further improvements in the technique and creation of robust diagnostic criteria are necessary. The purpose of this study was to compare the usefulness of strain elastography and a new generation of elasticity imaging called supersonic shear wave elastography (SSWE) in differential evaluation of thyroid nodules. Six thyroid nodules in 4 patients were studied. SSWE yielded 1 true-positive and 5 true-negative results. Strain elastography yielded 5 false-positive results and 1 false-negative result. A novel finding appreciated with SSWE, were punctate foci of increased stiffness corresponding to microcalcifications in 4 nodules, some not visible on B-mode ultrasound, as opposed to soft, colloid-inspissated areas visible on B-mode ultrasound in 2 nodules. This preliminary paper indicates that SSWE may outperform strain elastography in differentiation of thyroid nodules with regard to their stiffness. SSWE showed the possibility of differentiation of high echogenic foci into microcalcifications and inspissated colloid, adding a new dimension to thyroid elastography. Further multicenter large-scale studies of thyroid nodules evaluating different elastographic methods are warranted.
尽管弹性成像可增强甲状腺结节的鉴别诊断，但目前其诊断性能并不理想。有必要进一步改进该技术并制定可靠的诊断标准。本研究的目的是比较应变弹性成像和新一代弹性成像技术——超声剪切波弹性成像（SSWE）在甲状腺结节鉴别评估中的效用。对4例患者的6个甲状腺结节进行了研究。SSWE得出1个真阳性和5个真阴性结果。应变弹性成像得出5个假阳性结果和1个假阴性结果。SSWE有一个新发现，即4个结节中与微钙化相对应的点状硬度增加灶，其中一些在B超上不可见，而2个结节中在B超上可见的是柔软的、浓缩胶体区域。这篇初步报告表明，在甲状腺结节硬度的鉴别方面，SSWE可能优于应变弹性成像。SSWE显示了将高回声灶区分为微钙化和浓缩胶体的可能性，为甲状腺弹性成像增添了新的维度。有必要进一步开展多中心大规模研究，以评估不同弹性成像方法对甲状腺结节的诊断价值。
