Wang Juan, He Xin, Ma Li, Li Miao, Sun Lei, Jiang Jue, Zhou Qi
Department of Ultrasound, The Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, China.
Department of Pathology, The Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, China.
PeerJ. 2020 May 4;8:e9112. doi: 10.7717/peerj.9112. eCollection 2020.
B-mode ultrasound is one of the most commonly used imaging techniques for evaluating thyroid nodules due to its noninvasive property and excellent performance in terms of discriminating between benign and malignant nodules. However, the accuracy of differential diagnosis strongly depends on the experience of ultrasonographers. In addition to B-mode ultrasound, the elastic mode and contrast-enhanced mode have shown complimentary value in the diagnosis of thyroid nodules. The combination of multiple modes in ultrasonic techniques may effectively undermine diagnostic subjectiveness and improve accuracy. In this study, we evaluated the diagnostic value of combining the three ultrasonic modes for differentiating thyroid cancers.
In this retrospective study, we analyzed a total of 196 thyroid nodules with suspected malignancies from 185 patients who gave informed consent. Xi'an Jiaotong University granted ethical approval (No. 2018200) to carry out the study within its facilities. All the patients received ultrasonic examinations with the B mode, elastic mode and contrast-enhanced mode, followed by histopathological confirmation by fine-need aspiration or surgery. A predictive multivariate logistic regression model was selected to integrate the variety of data obtained from the three modes.
The combination of three ultrasonic techniques for differentiating malignant from benign thyroid nodules showed the highest diagnostic accuracy of 0.985 compared to the B mode alone (0.841) and the two-mode combination. The accuracy of the B mode combined with the elastic technique was 0.954, and the accuracy of the B mode combined with the contrast-enhanced technique was 0.960.
Multimode ultrasonic techniques should be recommended to patients with suspected malignant thyroid nodules in routine clinical practice.
B 型超声因其无创性以及在鉴别甲状腺结节良恶性方面的出色表现，是评估甲状腺结节最常用的成像技术之一。然而，鉴别诊断的准确性很大程度上取决于超声检查人员的经验。除了 B 型超声外，弹性成像模式和超声造影模式在甲状腺结节诊断中也显示出互补价值。超声技术中多种模式的结合可能有效降低诊断的主观性并提高准确性。在本研究中，我们评估了三种超声模式联合用于鉴别甲状腺癌的诊断价值。
在这项回顾性研究中，我们分析了 185 例签署知情同意书的疑似甲状腺恶性结节患者的总共 196 个甲状腺结节。西安交通大学批准了伦理许可（编号 2018200），允许在其机构内开展本研究。所有患者均接受了 B 型、弹性成像和超声造影模式的超声检查，随后通过细针穿刺抽吸或手术进行组织病理学确认。选择一个预测性多变量逻辑回归模型来整合从三种模式获得的各种数据。
与单独使用 B 型超声（0.841）和两种模式联合相比，三种超声技术联合鉴别甲状腺良恶性结节的诊断准确性最高，为 0.985。B 型超声与弹性成像技术联合的准确性为 0.954，B 型超声与超声造影技术联合的准确性为 0.960。
在常规临床实践中，对于疑似甲状腺恶性结节的患者，应推荐使用多模式超声技术。
