University of Health Sciences, Adana Health Practice and Research Center, Department of Otorhinolaryngology, Adana, Turkey.
University of Health Sciences, Adana Health Practice and Research Center, Radiology Department, Adana, Turkey.
Braz J Otorhinolaryngol. 2021 May-Jun;87(3):338-345. doi: 10.1016/j.bjorl.2020.05.017. Epub 2020 Jun 25.
Only 5%-15% of thyroid surgical specimens are reported as malignant. Most of the operations are performed due to suspicion of malignancy as a result of fine needle aspiration biopsy but invasiveness, non-diagnostic results and potential repeat biopsies are disadvantages of fine needle aspiration biopsy.
The aim of this study was to investigate the effectiveness of simultaneously using both the strain ratio and elasticity score in the differential diagnosis of thyroid nodules, as well as to assess the compatibility of these two methods.
A total of 144 nodules were included in the study. The final histopathologic diagnosis was used as the reference standard. The area under the curve sensitivity, specificity, and cut-off values of the strain ratio and elasticity score were determined using receiver operating characteristic curve analysis. The compatibility and comparison of strain ratio and elasticity score were also performed.
Twenty eight nodules (19.4%) were malignant. The strain ratio and elasticity score results were found to be significantly successful in predicting thyroid malignancy (p < 0.001 for both). Moreover, the area under the curve for the strain ratio and elasticity score were found to be 0.944 and 0.960, respectively. The diagnostic accuracy of the elasticity score was found to be superior to that of the strain ratio, but this difference was not statistically significant (p = 0.456). When the compatibility of the strain ratio and elasticity score was examined, the two evaluations were revealed to be statistically consistent with each other (Kappa = 0.767; p < 0.001). When the strain ratio and the elasticity score were used together, the specificity of capturing the correct diagnosis increased from 84.5% to 93.1%.
When the strain ratio an elasticity score were used together for the differential diagnosis of thyroid nodules, more accurate results were obtained. Thus, combining both methods may be a promising alternative to fine needle aspiration biopsy in order to prevent unnecessary surgical interventions for suspected thyroid nodules.
仅有 5%-15%的甲状腺手术标本被报告为恶性。大多数手术是由于细针穿刺抽吸活检怀疑恶性而进行的，但细针穿刺抽吸活检具有侵袭性、非诊断结果和潜在的重复活检等缺点。
本研究旨在探讨同时使用应变比和弹性评分对甲状腺结节进行鉴别诊断的效果，并评估这两种方法的兼容性。
共纳入 144 个结节。最终的组织病理学诊断作为参考标准。使用接收者操作特征曲线分析确定应变比和弹性评分的曲线下面积、敏感性、特异性和截断值。还进行了应变比和弹性评分的兼容性和比较。
28 个结节（19.4%）为恶性。应变比和弹性评分结果均显著成功地预测了甲状腺恶性肿瘤（均为 p<0.001）。此外，应变比和弹性评分的曲线下面积分别为 0.944 和 0.960。弹性评分的诊断准确性优于应变比，但差异无统计学意义（p=0.456）。当检查应变比和弹性评分的兼容性时，发现这两种评估具有统计学一致性（Kappa=0.767；p<0.001）。当同时使用应变比和弹性评分时，捕捉正确诊断的特异性从 84.5%提高到 93.1%。
当同时使用应变比和弹性评分对甲状腺结节进行鉴别诊断时，可获得更准确的结果。因此，联合使用这两种方法可能是替代细针穿刺抽吸活检以避免对可疑甲状腺结节进行不必要的手术干预的一种有前途的方法。
