Schenke Simone, Zimny Michael
Institute for Nuclear Medicine Hanau/Gießen/Frankfurt/Offenbach, Gießen, Germany.
Institute for Nuclear Medicine Hanau/Gießen/Frankfurt/Offenbach, Hanau, Germany.
Ultrasound Med Biol. 2018 Mar;44(3):575-583. doi: 10.1016/j.ultrasmedbio.2017.11.017. Epub 2018 Jan 2.
To evaluate the diagnostic performance of elastography alone and combined with Thyroid Imaging Reporting And Data System (TIRADS) for the assessment of non-autonomous thyroid nodules. We included 244 thyroid nodules and analyzed the visual elasticity scores, strain value (SV) and TIRADS classification. Histologic examination revealed 38 malignant (16%) and 206 benign nodules. The SV was lower in malignant nodules than in benign with an optimal cutoff ≤0.225. The visual elasticity scores showed a better diagnostic performance than the SV measurement. The risk for malignancy increased with higher TIRADS category. The sensitivity, specificity, positive predictive value and negative predictive value of TIRADS were superior to sonoelastography. The combination of TIRADS ≥4C and SV ≤0.225 showed the highest odds ratio to predict malignancy. Kwak-TIRADS classification is superior to elastography for the differentiation of benign and malignant thyroid nodules. Our data demonstrate that a high TIRADS class alone is predictive for thyroid carcinoma and the clinical relevance of sonoelastography is negligible.
评估弹性成像单独及联合甲状腺影像报告和数据系统（TIRADS）对非自主性甲状腺结节的诊断性能。我们纳入了244个甲状腺结节，分析了视觉弹性评分、应变值（SV）和TIRADS分类。组织学检查显示38个恶性结节（16%）和206个良性结节。恶性结节的SV低于良性结节，最佳截断值≤0.225。视觉弹性评分的诊断性能优于SV测量。TIRADS类别越高，恶性风险越高。TIRADS的敏感性、特异性、阳性预测值和阴性预测值均优于超声弹性成像。TIRADS≥4C且SV≤0.225的组合预测恶性肿瘤的比值比最高。Kwak-TIRADS分类在鉴别甲状腺良恶性结节方面优于弹性成像。我们的数据表明，单独的高TIRADS类别可预测甲状腺癌，超声弹性成像的临床相关性可忽略不计。
