Liu Bo-Ji, Zhang Yi-Feng, Zhao Chong-Ke, Wang Han-Xiang, Li Ming-Xu, Xu Hui-Xiong
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. 2020;75(3):291-301. doi: 10.3233/CH-190750.
The purpose of the study was to explore the differences of conventional ultrasound characteristics, thyroid imaging reporting and data system (TI-RADS) category and shear wave speed (SWS) measurement between follicular adenoma (FA) and follicular thyroid carcinoma (FTC). Twenty-eight FTCs and 67 FAs proven by surgery were retrospectively included for analysis. Conventional ultrasound and point-shear wave elastography (p-SWE) were performed in all of the included patients. The ultrasound features, American Thyroid Association (ATA) TI-RADS category and American College of Radiology (ACR) TI-RADS category, SWS measurement were compared between the two groups. Receiver operating characteristic (ROC) curve was performed and area under ROC curve (AUC) was obtained for significant features. There were no statistical differences in mean age (46.9±15.7years vs. 48.6±13.6years, P = 0.639), gender (9 males, 32.1% vs. 18 males, 29.0%, P = 0.766) and mean diameter (28.3±16.2 mm vs. 33.8±11.9 mm, P = 0.077) between FTCs and FAs. Hypoechogenicity, lobulated or irregular margin, macrocalcification were more common in FTCs than FAs (all P < 0.05). Mean SWS of FTCs (2.29±0.64 m/s) was slightly higher than that of FAs (1.94±0.68 m/s) (P = 0.023). The AUCs were 0.655, 0.744, and 0.744 with the cut-off SWS≥1.89 m/s, ACR TI-RADS category 4 and intermediate suspicion of ATA TI-RADS category. The sensitivity and AUC were 82.1% and 0.812 with combined ultrasound features of hypoechogenicity, lobulated or irregular margin and macrocalcification. In Conclusion, SWS measurement and TI-RADS categories were useful for the identification of FTCs from FAs.
本研究的目的是探讨滤泡性腺瘤（FA）与滤泡状甲状腺癌（FTC）之间在常规超声特征、甲状腺影像报告和数据系统（TI-RADS）分类以及剪切波速度（SWS）测量方面的差异。回顾性纳入28例经手术证实的FTC和67例FA进行分析。对所有纳入患者进行常规超声和点剪切波弹性成像（p-SWE）检查。比较两组之间的超声特征、美国甲状腺协会（ATA）TI-RADS分类和美国放射学会（ACR）TI-RADS分类、SWS测量结果。绘制受试者操作特征（ROC）曲线并获得ROC曲线下面积（AUC）以确定显著特征。FTC和FA在平均年龄（46.9±15.7岁 vs. 48.6±13.6岁，P = 0.639）、性别（9例男性，32.1% vs. 18例男性，29.0%，P = 0.766）和平均直径（28.3±16.2mm vs. 33.8±11.9mm，P = 0.077）方面无统计学差异。FTC中低回声、分叶状或不规则边缘、粗大钙化比FA更常见（所有P < 0.05）。FTC的平均SWS（2.29±0.64m/s）略高于FA（1.94±0.68m/s）（P = 0.023）。当截断SWS≥1.89m/s、ACR TI-RADS分类为4类以及ATA TI-RADS分类为中度可疑时，AUC分别为0.655、0.744和0.744。低回声、分叶状或不规则边缘和粗大钙化的联合超声特征的敏感性和AUC分别为82.1%和0.812。总之，SWS测量和TI-RADS分类有助于从FA中鉴别出FTC。
