Turk J Med Sci. 2018 Oct 31;48(5):1048-1052. doi: 10.3906/sag-1802-195.
Background/aim: In the general population, the frequency of thyroid micronodules is increasing, and the prevalence of malignancy is higher for such nodules. Ultrasonography findings of these nodules are neither specific nor sensitive. The aim of this study was to investigate the diagnostic value of elastography in patients with thyroid micronodules. Materials and methods: A total of 224 patients with thyroid micronodules were recruited in this prospective study. All patients underwent a thyroid fine-needle aspiration biopsy. Elastography scores (ESs) and strain indexes (SIs) were measured with real-time ultrasound elastography. Results: Malignant micronodules had higher ES and SI values than those of benign micronodules (P < 0.001). When ES was used to diagnose malignancy, scores of >3 showed sensitivity of 79.4% and specificity of 98.1%. The area under the curve (AUC) for ES was 0.888 (P < 0.001). The optimal SI cutoff value that differentiated benign from malignant micronodules was 3.06 (98% sensitivity; 91% specificity). The AUC for SI was 0.970 (P < 0.001). Conclusions: ES and SI are beneficial markers for detecting malignant thyroid micronodules. We showed that SI is better than ES when assessing the malignancy of thyroid micronodules.
背景/目的：在普通人群中，甲状腺微小结节的频率正在增加，此类结节的恶性肿瘤患病率更高。这些结节的超声检查结果既不具有特异性，也不具有敏感性。本研究旨在探讨超声弹性成像在甲状腺微小结节患者中的诊断价值。
本前瞻性研究共纳入 224 例甲状腺微小结节患者。所有患者均接受甲状腺细针抽吸活检。实时超声弹性成像测量弹性成像评分（ES）和应变指数（SI）。
恶性微小结节的 ES 和 SI 值高于良性微小结节（P<0.001）。当 ES 用于诊断恶性肿瘤时，评分>3 的灵敏度为 79.4%，特异性为 98.1%。ES 的曲线下面积（AUC）为 0.888（P<0.001）。区分良性和恶性微小结节的最佳 SI 截断值为 3.06（98%的灵敏度；91%的特异性）。SI 的 AUC 为 0.970（P<0.001）。
ES 和 SI 是检测甲状腺恶性微小结节的有益标志物。我们表明，在评估甲状腺微小结节的恶性程度时，SI 优于 ES。
