Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Medicine, Faculty of Health, Aarhus University , Aarhus, Denmark.
J Endocrinol Invest. 2021 Oct;44(10):2043-2056. doi: 10.1007/s40618-021-01570-z. Epub 2021 Apr 16.
Shear wave elastography (SWE), as a tool for diagnosing thyroid malignancy, has gathered considerable attention during the past decade. Diverging results exist regarding the diagnostic performance of thyroid SWE.
A comprehensive literature review of thyroid SWE was conducted using the terms "Thyroid" and "shear wave elastography" in PubMed.
The majority of studies found SWE promising for differentiating malignant and benign thyroid nodules on a group level, whereas results are less convincing on the individual level due to huge overlap in elasticity indices. Further, there is lack of consensus on the optimum outcome reflecting nodule elasticity and the cut-off point predicting thyroid malignancy. While heterogeneity between studies hinders a clinically meaningful meta-analysis, the results are discussed in a clinical perspective with regard to applicability in clinical practice as well as methodological advantages and pitfalls of this technology.
Technological as well as biological hindrances seem to exist for SWE to be clinically reliable in assessing benign and malignant thyroid nodules. Structural heterogeneity of thyroid nodules in combination with operator-dependent factors such as pre-compression and selection of scanning plane are likely explanations for these findings. Standardization and consensus on the SWE acquisition process applied in future studies are needed for SWE to be considered a clinically reliable diagnostic tool for detection of thyroid cancer.
剪切波弹性成像（SWE）作为诊断甲状腺恶性肿瘤的工具，在过去十年中受到了广泛关注。关于甲状腺 SWE 的诊断性能存在不同的结果。
在 PubMed 中使用“甲状腺”和“剪切波弹性成像”这两个术语对甲状腺 SWE 进行了全面的文献回顾。
大多数研究发现 SWE 在群体水平上对区分恶性和良性甲状腺结节具有很大的应用潜力，但是在个体水平上的结果并不令人信服，因为弹性指数之间存在很大的重叠。此外，在反映结节弹性的最佳结果和预测甲状腺恶性肿瘤的截断点方面尚未达成共识。尽管研究之间的异质性阻碍了有临床意义的荟萃分析，但从临床角度讨论了这些结果，涉及该技术在临床实践中的适用性以及方法学的优缺点。
SWE 在评估良性和恶性甲状腺结节方面具有临床可靠性似乎存在技术和生物学上的障碍。甲状腺结节的结构异质性以及操作人员依赖性因素（如预压缩和扫描平面的选择）可能是造成这些发现的原因。需要对未来研究中应用的 SWE 采集过程进行标准化和达成共识，以便将 SWE 视为一种可靠的临床诊断工具，用于检测甲状腺癌。
