Department of Ultrasound, Peking University Third Hospital, Beijing, 100191, China.
Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
Eur J Radiol. 2021 Apr;137:109571. doi: 10.1016/j.ejrad.2021.109571. Epub 2021 Jan 29.
We aimed to assess the diagnostic performance of shear wave elastography (SWE) to assess perinodular stiffness before fine needle aspiration (FNA) of thyroid nodules with a maximum diameter of 1.0 cm.
This retrospective study included 69 thyroid nodules in 68 patients who underwent conventional ultrasound and SWE before ultrasound-guided FNA or surgical excision. The stiffness of perinodular regions was evaluated using wave patterns. Quantitative SWE features were also assessed. Sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve were calculated using conventional ultrasound and conventional ultrasound with SWE.
Of the 69 nodules, 57(82.6 %)were malignant and 12(17.4 %)were benign. The maximum elastic modulus (Emax) was higher for malignant nodules(P＜ 0.05). There was no significant difference in mean elastic modulus or minimum elastic modulus between malignant and benign nodules. The Emax≥ 28.2 kPa was the best cut-off value for malignant base on receiver operating curve. Perinodular stiffness was significantly greater for malignant nodules compared with benign nodules according to shear wave patterns. Compared with ultrasound alone, the rate of benign lesions recommended for FNA decreased from 75.0 % (9/12) to 25.0 % (3/12) with conventional ultrasound plus SWE.
SWE provides quantitative and qualitative information when used with conventional ultrasound. SWE has the potential to reduce the number of unnecessary FNA procedures.
我们旨在评估剪切波弹性成像（SWE）在直径最大为 1.0cm 的甲状腺结节行细针抽吸（FNA）前评估结节周围硬度的诊断性能。
本回顾性研究纳入了 68 例患者的 69 个甲状腺结节，这些患者在超声引导下 FNA 或手术切除前行常规超声和 SWE 检查。采用波型评估结节周围区域的硬度。还评估了定量 SWE 特征。使用常规超声和常规超声联合 SWE 计算敏感性、特异性、准确性和受试者工作特征曲线下面积。
在 69 个结节中，57 个（82.6%）为恶性，12 个（17.4%）为良性。恶性结节的最大弹性模量（Emax）较高（P＜0.05）。恶性和良性结节之间的平均弹性模量或最小弹性模量无显著差异。基于受试者工作曲线，Emax≥28.2kPa 是恶性的最佳截断值。根据剪切波模式，恶性结节的结节周围硬度明显大于良性结节。与单纯超声相比，常规超声联合 SWE 可将推荐行 FNA 的良性病变的比例从 75.0%（9/12）降低至 25.0%（3/12）。
SWE 与常规超声联合使用可提供定量和定性信息。SWE 有可能减少不必要的 FNA 操作次数。
