Liu Bo-Ji, Zhao Chong-Ke, Xu Hui-Xiong, Zhang Yi-Feng, Xu Jun-Mei, Li Dan-Dan, Bo Xiao-Wan, Li Xiao-Long
Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai 200072, China.
Thyroid Institute, Tongji University School of Medicine, Shanghai Center for Thyroid Diseases, Shanghai 200072, China.
Oncotarget. 2017 Jan 17;8(3):4848-4959. doi: 10.18632/oncotarget.13996.
To evaluate the associated factors for quality measurement (QM) on shear wave speed (SWS) imaging and the additional value of QM for differentiation of thyroid nodules. A consecutive series of 238 patients with 254 thyroid nodules were enrolled. They were all evaluated by conventional ultrasound and SWS imaging and were finally proven pathologically. QM was used to assess whether SWS propagation was authentic and was classified as high QM and Low QM. Twelve variables were analyzed to evaluate the associated factors for QM using binary logistic regression. Receiver operating characteristic (ROC) curve was plotted on SWS and SWS+QM. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and area under ROC curve (AUC) were calculated. The study included 170 benign thyroid nodules (160 high QM and 10 low QM) and 84 malignant thyroid nodules (56 high QM and 28 low QM) (P < 0.001). The mean SWS of benign and malignant nodules were 2.51 ± 0.47 m/s and 3.43 ± 1.21 m/s respectively (P < 0.001). The sensitivities, specificities, PPVs, NPVs, accuracies and AUCs were 77.4%, 80.0%, 65.7%, 87.7%, 79.1%, 0.82 for SWS alone with SWS ≥ 2.78 m/s; 33.3-34.5%, 91.2-94.1%, 65.9-73.7%, 73.8-74.1%, 72.4-74.0%, 0.63-0.64 for QM alone and 84.5-85.7%, 72.4-75.9%, 60.5-63.4%, 90.8-91.0%, 76.8-78.7%, 0.79-0.80 for SWS+QM. Nodule depth was identified to be the strongest associated factor for QM of SWS, followed by malignancy and SWS. In conclusion, QM for thyroid nodule is associated with nodule depth, malignancy, and SWS. QM improves the specificity in comparison with SWS alone, whereas SWS+QM does not improve the overall diagnostic performance.
评估剪切波速度（SWS）成像质量测量（QM）的相关因素以及QM对甲状腺结节鉴别诊断的附加价值。纳入了连续的238例患者，共254个甲状腺结节。所有患者均接受了传统超声和SWS成像检查，并最终经病理证实。QM用于评估SWS传播是否真实，并分为高QM和低QM。使用二元逻辑回归分析12个变量以评估QM的相关因素。绘制了SWS和SWS+QM的受试者操作特征（ROC）曲线。计算了敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）、准确性和ROC曲线下面积（AUC）。该研究包括170个良性甲状腺结节（160个高QM和10个低QM）和84个恶性甲状腺结节（56个高QM和28个低QM）（P<0.001）。良性和恶性结节的平均SWS分别为2.51±0.47m/s和3.43±1.21m/s（P<0.001）。单独SWS（SWS≥2.78m/s）时的敏感性、特异性、PPV、NPV、准确性和AUC分别为77.4%、80.0%、65.7%、87.7%、79.1%、0.82；单独QM时为33.3 - 34.5%、91.2 - 94.1%、65.9 - 73.7%、73.8 - 74.1%、72.4 - 74.0%、0.63 - 0.64；SWS+QM时为84.5 - 85.7%、72.4 - 75.9%、60.5 - 63.4%、90.8 - 91.0%、76.8 - 78.7%、0.79 - 0.80。结节深度被确定为SWS的QM最强相关因素，其次是恶性程度和SWS。总之，甲状腺结节的QM与结节深度、恶性程度和SWS相关。与单独的SWS相比，QM提高了特异性，而SWS+QM并未提高整体诊断性能。
