Department of Radiology, Oncology, and Anatomy Pathology, University "La Sapienza", Rome, Italy.
Eur J Radiol. 2013 Nov;82(11):1892-8. doi: 10.1016/j.ejrad.2013.07.005. Epub 2013 Aug 6.
To assess the effectiveness of semiquantitative elastosonography (Q-elastography) compared with contrast-enhanced ultrasound (CEUS) in differentiating the nature of thyroid nodules.
Forty-eight consecutive patients (35 males, 13 females, range: 34-69 years, mean: 49.4 years), candidate to surgery, previously detected at color-Doppler ultrasound (CDUS), were prospectively examined with elastosonography with dedicated semiquantitative software (Q-Elastography, Toshiba XG) and CEUS (Technos Mylab 70 Gold X, and Toshiba XG) before surgery. CEUS and elastosonography were evaluated by two investigators in consensus. Comparison between the CEUS pattern and elastonographic strain ratio observed and expected frequencies for the diagnoses was evaluated with χ(2) test or with Fisher exact test.
Fifty-three nodules (19 papillary carcinoma, 32 hyperplasia, and 2 follicular adenoma) in 48 patients were available for analysis. Regarding echogenicity score, sensitivity, specificity, PPV and NPV of conventional US were 81%, 50%, 56%, 77%; according to Q-elastography, sensitivity, specificity, PPV and NPV were 95%, 88%, 97% and 91% respectively; whereas concerning CEUS, sensitivity specificity PPV and NPV were 79%, 91%, 83% and 89% respectively. Both CEUS and Q-elastography were more specific than US (p<0.01), with not statistical significant difference with regard to sensitivity.
The results of the present study suggest that Q-elastography is a valuable tool in the characterization of thyroid nodules and it seems to be more sensitive than CEUS.
评估半定量超声弹性成像（Q 弹）与超声造影（CEUS）在鉴别甲状腺结节性质方面的有效性。
48 例连续患者（35 名男性，13 名女性，年龄范围：34-69 岁，平均年龄：49.4 岁），之前在彩色多普勒超声（CDUS）检查中发现，在手术前前瞻性地使用专用半定量软件（Q-Elastography，东芝 XG）和 CEUS（Technos Mylab 70 Gold X 和东芝 XG）进行弹性成像检查。CEUS 和弹性成像由两名研究人员进行一致性评估。通过卡方检验或 Fisher 确切概率检验评估 CEUS 模式与弹性应变比观察值和预期诊断频率之间的差异。
48 例患者的 53 个结节（19 个乳头状癌，32 个增生，2 个滤泡性腺瘤）可用于分析。常规 US 的回声评分、灵敏度、特异性、PPV 和 NPV 分别为 81%、50%、56%、77%；根据 Q 弹，灵敏度、特异性、PPV 和 NPV 分别为 95%、88%、97%和 91%；而对于 CEUS，灵敏度、特异性、PPV 和 NPV 分别为 79%、91%、83%和 89%。CEUS 和 Q 弹都比 US 更具特异性（p<0.01），但在灵敏度方面没有统计学差异。
本研究结果表明，Q 弹是一种有价值的甲状腺结节特征分析工具，其敏感性似乎高于 CEUS。
