Na Z Y, Qiao Q, Wang Q C, Zhou M Y, Yuan S S, Wen X, Cheng W
Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin, 150081, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Aug 5;31(15):1191-1195. doi: 10.13201/j.issn.1001-1781.2017.15.012.
In order to improve diagnostic accuracy, we study the characteristics of two dimensional ultrasound and shear wave elastography in the diagnosis of false negative or false positive thyroid nodules by shear wave elastography.One hundred and eighty-nine nodules in 189 consecutive patients who had been determined by surgical operation and pathology. Conventional ultrasound features and SWE elasticity imaging characteristics and properties of the final postoperative pathology were recorded. A comparative study between true and false results of quantitative SWE elasticity imaging, and the corresponding conventional ultrasound nodule characteristics were compared.Postoperative pathology showed 189 nodules, 74(39.2%) were benign and 115(60.8%) were malignant. The sensitivity, specificity of conventional ultrasound in the diagnosis of thyroid nodules were 56.5% and 81.1% respectively, and those of SWE were 60.9% and 85.1%. The false positive rate of shear wave elastography in diagnosing benign nodules and the false negative rate of malignant nodules were 14.9% and 39.1%, respectively. The false negative rate was higher than the false positive rate. A vertical growth (< 0.01) and smaller diameter of the masses were significantly associated with false SWE findings (< 0.01).The SWE imaging has important significance for differentiating benign and malignant thyroid nodules, but false results are inevitable, which requires clinicians conjunction with other test results to prevent errors judgment when reviewing the SWE imaging.
为提高诊断准确性，我们研究二维超声和剪切波弹性成像在剪切波弹性成像诊断甲状腺结节假阴性或假阳性中的特征。对189例经手术及病理确诊的连续患者的189个结节进行研究。记录常规超声特征、剪切波弹性成像（SWE）特征及最终术后病理特征。对SWE弹性成像定量结果的真假进行对比研究，并比较相应的常规超声结节特征。术后病理显示189个结节中，74个（39.2%）为良性，115个（60.8%）为恶性。常规超声诊断甲状腺结节的敏感性、特异性分别为56.5%和81.1%，SWE的敏感性、特异性分别为60.9%和85.1%。剪切波弹性成像诊断良性结节的假阳性率和诊断恶性结节的假阴性率分别为14.9%和39.1%。假阴性率高于假阳性率。肿块垂直生长（<0.01）和较小直径与SWE假结果显著相关（<0.01）。SWE成像对鉴别甲状腺结节的良恶性具有重要意义，但假结果不可避免，这就要求临床医生在解读SWE成像时结合其他检查结果以防止错误判断。
