Ko Su Yeon, Kim Eun-Kyung, Sung Ji Min, Moon Hee Jung, Kwak Jin Young
Department of Radiology, Severance Hospital, Research Institute of Radiologic Science, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Radiology, Jeju National University Hospital, Jeju National School of Medicine, Jeju City, Republic of Korea.
Department of Radiology, Severance Hospital, Research Institute of Radiologic Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
Ultrasound Med Biol. 2014 May;40(5):854-63. doi: 10.1016/j.ultrasmedbio.2013.10.005. Epub 2013 Dec 7.
The aim of this study was to compare the diagnostic performance of gray-scale ultrasound (US), elastography and a combination of gray-scale ultrasound and elastography (US-E) in differentiating benign and malignant thyroid nodules with respect to the level of physician experience. Three hundred fifty-eight patients with 367 thyroid nodules who underwent both gray-scale US and elastography, from November 2011 to January 2012, were included in this study. The diagnostic performance of US performed by experienced and less experienced physicians was compared. Comparisons of the diagnostic performance of US, elastography and US-E were evaluated for each group separately. Of 367 nodules, 121 were malignant and 246 were benign. When we compared the diagnostic performance of the experienced and less experienced physician groups, specificity was statistically higher in the experienced physician group for both US alone (p = 0.001) and US-E (p = 0.048). However, the experienced and less experienced physician groups did not differ significantly on other measures of diagnostic performance, regardless of modality. For the experienced physicians, the specificity and positive predictive value US were 88.0% and 76.8%, respectively; both of them were significantly higher than the corresponding values for US-E. For the less experienced physicians, specificity was significantly higher on elastography (93.8%) than on US (71.4%) (p < 0.001). However, diagnostic performance did not differ significantly between US and US-E for the less experienced physicians. Experienced physicians had superior specificity compared with less experienced physicians. The diagnostic performance of elastography and US-E was inferior compared with that of US alone, irrespective of the level of experience of the physician.
本研究的目的是比较灰阶超声（US）、弹性成像以及灰阶超声与弹性成像联合检查（US-E）在鉴别甲状腺良恶性结节方面的诊断性能，同时考虑医生经验水平的影响。本研究纳入了2011年11月至2012年1月期间接受灰阶超声和弹性成像检查的358例患者，共367个甲状腺结节。比较了经验丰富和经验较少的医生进行灰阶超声检查的诊断性能。分别对每组中US、弹性成像和US-E的诊断性能进行比较。367个结节中，121个为恶性，246个为良性。当我们比较经验丰富和经验较少的医生组的诊断性能时，经验丰富的医生组在单独使用US（p = 0.001）和US-E（p = 0.048）时，特异性在统计学上更高。然而，无论采用何种检查方式，经验丰富和经验较少的医生组在其他诊断性能指标上并无显著差异。对于经验丰富的医生，US的特异性和阳性预测值分别为88.0%和76.8%；两者均显著高于US-E的相应值。对于经验较少的医生，弹性成像的特异性（93.8%）显著高于US（71.4%）（p < 0.001）。然而，对于经验较少的医生，US和US-E之间的诊断性能并无显著差异。经验丰富的医生比经验较少的医生具有更高的特异性。无论医生经验水平如何，弹性成像和US-E的诊断性能均低于单独使用US的诊断性能。
