Şahin Mustafa, Çakal Erman, Özbek Mustafa, Güngünes Aşkin, Arslan Müyesser Sayki, Akkaymak Esra Tutal, Uçan Bekir, Ünsal Ilknur Öztürk, Bozkurt Nujen Çolak, Delibaşi Tuncay
Endocrinology and Metabolism Department, Ankara University School of Medicine, İbni Sina Hastanesi Ek Bina M-blok Kat:1, 06100, Sıhhıye, Ankara, Turkey,
Med Oncol. 2014 Aug;31(8):97. doi: 10.1007/s12032-014-0097-2. Epub 2014 Jul 3.
Elastography is a method which assesses the risk of the malignancy and provides information about the degree of hardness in tissue. Hashimoto's thyroiditis, autoimmune lymphocytic infiltration and fibrosis, is considered to be a very common disease that is able to change the hardness of the tissue. The diagnostic value of elastography of this group of patients has not previously been reported. In our study, we aimed to determine the diagnostic value of elastography in 283 patients (255 female, 28 male) with Hashimoto's thyroiditis. Elastography score and index were measured with real-time ultrasound elastography (Hitachi(®) EUB 7000 HV machine with using 13 MHz linear transducer). The outcome of this measure shows that malignant nodules were with higher elastography scores (ES) and strain indexes (SI) values. ES ≥3 were observed in 16/20 malignant and 130/263 benign nodules, respectively. The area under the curve (AUC) for the elasto score (AUC) was 0.72 (p = 0.001), and AUC for the strain index was 0.77 (p < 0.0001). Accordingly, our study suggests that strain index reflects malignancy better than the elasto score. We conclude that elastography score is ≥3 providing 80 % sensitivity and 50 %, six specificity for diagnosing malignancy. For strain index, we found that 2.45 (72.2 % sensitivity and 70 % specificity) is a cut-off point. We have detected a lower cut-off point for SI in Hashimoto patients although sensitivity and specificity decreases in Hashimoto in this population.
弹性成像术是一种评估恶性肿瘤风险并提供组织硬度信息的方法。桥本甲状腺炎，即自身免疫性淋巴细胞浸润和纤维化，被认为是一种非常常见的能够改变组织硬度的疾病。此前尚未报道过弹性成像术对这类患者的诊断价值。在我们的研究中，我们旨在确定弹性成像术对283例（255例女性，28例男性）桥本甲状腺炎患者的诊断价值。使用实时超声弹性成像（日立（®）EUB 7000 HV机器，配备13 MHz线性换能器）测量弹性成像评分和指数。该测量结果表明，恶性结节的弹性成像评分（ES）和应变指数（SI）值较高。在20个恶性结节和263个良性结节中，分别有16个和130个观察到ES≥3。弹性评分的曲线下面积（AUC）为0.72（p = 0.001），应变指数的AUC为0.77（p < 0.0001）。因此，我们的研究表明，应变指数比弹性评分能更好地反映恶性程度。我们得出结论，弹性成像评分≥3时，对恶性肿瘤诊断的敏感性为80%，特异性为50%。对于应变指数，我们发现2.45（敏感性为72.2%，特异性为70%）是一个临界点。我们在桥本患者中检测到了较低的SI临界点，尽管在该人群中桥本患者的敏感性和特异性有所下降。
