Cho Yoon Joo, Ha Eun Ju, Han Miran, Choi Jin Wook
Department of Radiology, Ajou University School of Medicine, Wonchon-Dong, Yeongtong-Gu, Suwon, Korea.
Department of Radiology, Ajou University School of Medicine, Wonchon-Dong, Yeongtong-Gu, Suwon, Korea.
Ultrasound Med Biol. 2017 Aug;43(8):1587-1595. doi: 10.1016/j.ultrasmedbio.2017.04.007. Epub 2017 May 17.
This study evaluated the diagnostic performance of ultrasound elastography (USE) using carotid arterial pulsation and determined the reproducibility of USE for thyroid nodules. A total of 148 patients with 173 thyroid nodules participated. The mean elasticity contrast index (ECI) was significantly higher in malignant nodules (3.1 ± 1.5) than in benign nodules (1.7 ± 0.8) (p < 0.001). When a cut-off ECI value of 3.5 was used, the diagnostic accuracy (78.6%) of gray-scale ultrasound (US) + ECI was the highest compared with that of the gray-scale US (76.9%) and ECI (67.1%). In 16 of 43 nodules (37.2%) with US-pathology, discordance could be correctly reclassified as benign (8 of 11) or malignant (8 of 32). The intra-class correlation coefficient for inter-observer agreement was 0.96, and those for intra-observer agreement were 0.97 and 0.98. Thyroid nodules with ECI values of >3.5 may have an additional value to increase the diagnostic accuracy for nodules with US-pathology discordance with reproducible results.
本研究评估了利用颈动脉搏动的超声弹性成像（USE）的诊断性能，并确定了USE对甲状腺结节的可重复性。共有148例患者的173个甲状腺结节参与研究。恶性结节的平均弹性对比指数（ECI）（3.1±1.5）显著高于良性结节（1.7±0.8）（p<0.001）。当使用ECI截止值3.5时，灰阶超声（US）+ECI的诊断准确率（78.6%）高于灰阶US（76.9%）和ECI（67.1%）。在43个超声与病理结果不符的结节中，有16个（37.2%）可正确重新分类为良性（11个中的8个）或恶性（32个中的8个）。观察者间一致性的组内相关系数为0.96，观察者内一致性的组内相关系数分别为0.97和0.98。ECI值>3.5的甲状腺结节可能具有额外价值，可提高对超声与病理结果不符的结节的诊断准确率，且结果具有可重复性。
