Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China.
Thyroid Institute, Tongji University School of Medicine, Shanghai, China.
Clin Hemorheol Microcirc. 2019;72(1):39-60. doi: 10.3233/CH-180452.
Ultrasound elastography has been introduced into clinical practice for a decade and arisen continuous increasing attention worldwide. Shear wave elastography (SWE) is a further extension of ultrasound elastography on the basis of strain elastography, providing a two-dimensional distribution map of tissue stiffness and quantitative measurement of the tissue stiffness in Young's modulus (kPa) and/or shear wave speed (m/s). The Society of Ultrasound in Medicine, Chinese Medical Association (CMA) has recently released a series of guidelines for the use of SWE, including the technique and principle of SWE, and use of SWE in liver fibrosis, breast, thyroid, and musculoskeletal system. Herein, a part of SWE in thyroid nodules is presented. In this guideline, the background, classification and technology of SWE, examination methods, diagnostic performance, prognosis evaluation, reproducibility, and limitations are discussed and recommendations are given. The recommendations are based on the published literatures with regard to SWE with different levels of evidence, particularly a mid-term result of the prospective multi-center clinical trial of SWE in thyroid, as well as the Society of Ultrasound in Medicine, CMA expert's consensus. The document provides an overall analysis of SWE in thyroid from clinical perspective, which aimed to provide recommendations to the clinicians with regard to the management of thyroid nodules by the assistance of SWE.
超声弹性成像是一种在应变弹性成像基础上发展起来的技术，它为组织硬度的二维分布图谱提供了定量测量，并以杨氏模量（kPa）和/或剪切波速度（m/s）来表示组织硬度。中国医师协会超声医师分会近期发布了一系列关于剪切波弹性成像（SWE）应用的指南，涵盖了 SWE 的技术原理、在肝纤维化、乳腺、甲状腺和肌肉骨骼系统中的应用等内容。本文呈现了指南中甲状腺结节部分的内容。在该指南中，讨论了 SWE 的背景、分类和技术、检查方法、诊断性能、预后评估、可重复性和局限性，并给出了推荐意见。这些推荐意见是基于发表的关于 SWE 的文献，并结合了不同证据水平的研究结果，尤其是 SWE 前瞻性多中心临床试验的中期结果，以及中国医师协会超声医师分会专家共识。本文从临床角度对甲状腺 SWE 进行了全面分析，旨在为临床医生提供在 SWE 辅助下管理甲状腺结节的建议。
