Radiology, Department of Medicine and Surgery, Monza, Italy.
Center of Biostatistics for Clinical Epidemiology, Department of Medicine and Surgery, Monza, Italy.
J Ultrasound Med. 2019 Jul;38(7):1713-1720. doi: 10.1002/jum.14857. Epub 2018 Nov 27.
The aim of this study was to evaluate the application of shear wave elastography (SWE) in the routine management of thyroid nodules, as a possible additional tool to the standard sonographic triage.
A total of 248 consecutive patients scheduled for ultrasound-guided thyroid fine-needle aspiration were included in the study. The presence of a pure colloid lesion was an exclusion criterion. Absolute and relative SWE stiffness measurements on color-coded elastograms, expressed in kilopascals and meters per second, were correlated with radiologic and pathologic features.
SWE values in thyroid nodules were significantly higher than normal thyroid tissue (P = .0001), proving the different elastic properties of the pathologic tissues. Regarding the radiologic characteristics of the nodules, SWE highest values were associated with the largest lesions (P = .0105) but independent from sonographic and Doppler findings. The SWE elasticity was not influenced by the characteristics of the biopsy smears. The final correlation between the SWE results and the pathologic diagnoses showed a trend in stiffness from tender tumors (follicular adenoma) to papillary thyroid carcinoma (P = .016).
SWE allows the identification of nodules within normal parenchyma; however, the present study does not confirm the potential role in differentiating between benign and malignant thyroid nodules.
本研究旨在评估剪切波弹性成像（SWE）在甲状腺结节常规管理中的应用，作为标准超声分诊的一种可能的附加工具。
本研究共纳入 248 例计划行超声引导下甲状腺细针抽吸活检的连续患者。纯胶体病变的存在是排除标准。在彩色弹性图上测量绝对和相对 SWE 硬度值，以千帕和米/秒表示，并与影像学和病理学特征相关联。
甲状腺结节的 SWE 值明显高于正常甲状腺组织（P = .0001），证明了病变组织的不同弹性特性。就结节的影像学特征而言，SWE 的最高值与最大的病变相关（P = .0105），但与超声和多普勒发现无关。SWE 弹性不受活检涂片特征的影响。SWE 结果与病理诊断的最终相关性显示出从柔软肿瘤（滤泡性腺瘤）到甲状腺乳头状癌（P = .016）的僵硬趋势。
SWE 可识别正常实质内的结节；然而，本研究并未证实其在区分良性和恶性甲状腺结节方面的潜在作用。
