Hang Jing, Li Fan, Qiao Xiao-Hui, Ye Xin-Hua, Li Ao, Du Lian-Fang
Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Department of Ultrasound, Shanghai General Hospital of Nanjing Medical University, Shanghai 200080, China.
Int J Endocrinol. 2018 Oct 9;2018:4923050. doi: 10.1155/2018/4923050. eCollection 2018.
The present study is aimed at evaluating the diagnostic value of combining shear wave elastography (SWE) parameters and the thyroid imaging reporting and data system (TIRADS) for differentiating between benign and malignant thyroid nodules.
Patients who underwent conventional ultrasonography (US) and SWE before surgery were enrolled in the current study. Each nodule was given a TIRADS risk score. The effectiveness of the SWE parameters was assessed by odds ratios (ORs). The SWE scoring risk stratification was proposed beyond 95% probability, and the desired values were obtained according to the log-normal distribution. The area under the receiver-operating characteristic (AUC) was used to compare the diagnostic performance between TIRADS-alone and TIRADS + SWE.
A total of 262 patients with 298 thyroid nodules were enrolled in our study. The pathological analyses were conducted on 121 benign and 177 malignant nodules. The AUC values for TIRADS-alone and TIRADS + SWE were 0.896 (accuracy 83.2%) and 0.917 (accuracy 84.2%), respectively. However, the TIRADS + SWE scores showed a higher specificity (88.4%) and positive predictive value (91.2%) as compared with the TIRADS-alone of 73.6% and 83.2%, respectively.
Combining SWE and TIRADS improves the specificity of TIRADS-alone in differentiating between benign and malignant thyroid nodules.
本研究旨在评估剪切波弹性成像（SWE）参数与甲状腺影像报告和数据系统（TIRADS）相结合对鉴别甲状腺良恶性结节的诊断价值。
纳入术前接受常规超声（US）和SWE检查的患者。每个结节给予TIRADS风险评分。通过比值比（OR）评估SWE参数的有效性。提出SWE评分风险分层超过95%概率，并根据对数正态分布获得期望值。采用受试者操作特征曲线（AUC）下面积比较单独TIRADS和TIRADS+SWE的诊断性能。
本研究共纳入262例患者，298个甲状腺结节。对121个良性结节和177个恶性结节进行了病理分析。单独TIRADS和TIRADS+SWE的AUC值分别为0.896（准确率83.2%）和0.917（准确率84.2%）。然而，与单独的TIRADS相比，TIRADS+SWE评分的特异性（88.4%）和阳性预测值（91.2%）更高，单独TIRADS的特异性和阳性预测值分别为73.6%和83.2%。
SWE与TIRADS相结合可提高单独TIRADS鉴别甲状腺良恶性结节的特异性。
