Department of Pediatrics, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Zhejiang, Hangzhou, China.
Department of Ultrasound, Shanghai Putuo District People's Hospital, Shanghai, China.
BMC Endocr Disord. 2022 Mar 24;22(1):75. doi: 10.1186/s12902-022-00994-9.
The present study aimed to quantify and differentiate the echo levels of papillary thyroid microcarcinomas (PTMCs) and micronodular goiters (MNGs) using the ultrasound grayscale ratio (UGSR) and to investigate the repeatability of UGSR.
The ultrasound (US) data of 241 patients with 265 PTMCs and 141 patients with 168 MNGs confirmed by surgery and pathology were retrospectively analyzed. All patients had received outpatient ultrasonic examination and preoperative ultrasonic positioning. The RADinfo radiograph reading system was used to measure the grayscales of PTMC, MNG, and thyroid tissues at the same gain level, and the UGSR values of the PTMC, MNG, and thyroid tissue were calculated. The patients were divided into outpatient examination, preoperative positioning, and mean value groups, and the receiver operating characteristic (ROC) curves were calculated to obtain the optimal UGSR threshold to distinguish PTMC from MNG. The interclass correlation coefficient (ICC) was used to assess the consistency of UGSR measured in three groups.
The UGSR values of the PTMC and MNG were 0.56 ± 0.14 and 0.80 ± 0.19 (t = 5.84, P < 0.001) in the outpatient examination group, 0.55 ± 0.14 and 0.80 ± 0.19 (t = 18.74, P < 0.001) in the preoperative positioning group, and 0.56 ± 0.12 and 0.80 ± 0.18 (t = 16.49, P < 0.001) in the mean value group. The areas under the ROC curves in the three groups were 0.860, 0.856, and 0.875, respectively. When the UGSR values for the outpatient examination, preoperative positioning, and mean value groups were 0.649, 0.646, and 0.657, respectively, each group obtained its largest Youden index. A reliable UGSR value was obtained between the outpatient examination and preoperative positioning groups (ICC = 0.79, P = 0.68).
UGSR is a simple and repeatable method to distinguish PTMC from MNG, and hence, can be widely applicable.
本研究旨在使用超声灰度比（UGSR）量化和区分甲状腺微小乳头状癌（PTMC）和微结节性甲状腺肿（MNG）的回声水平，并研究 UGSR 的可重复性。
回顾性分析了 241 例经手术和病理证实的 265 例 PTMC 和 141 例 168 例 MNG 患者的超声（US）数据。所有患者均接受了门诊超声检查和术前超声定位。使用 RADinfo 射线照相阅读系统在相同增益水平下测量 PTMC、MNG 和甲状腺组织的灰度值，并计算 PTMC、MNG 和甲状腺组织的 UGSR 值。将患者分为门诊检查、术前定位和平均值组，计算受试者工作特征（ROC）曲线以获得最佳 UGSR 阈值，以区分 PTMC 和 MNG。采用组内相关系数（ICC）评估三组 UGSR 测量的一致性。
门诊检查组 PTMC 和 MNG 的 UGSR 值分别为 0.56±0.14 和 0.80±0.19（t=5.84，P<0.001），术前定位组分别为 0.55±0.14 和 0.80±0.19（t=18.74，P<0.001），平均值组分别为 0.56±0.12 和 0.80±0.18（t=16.49，P<0.001）。三组 ROC 曲线下面积分别为 0.860、0.856 和 0.875。当门诊检查、术前定位和平均值组的 UGSR 值分别为 0.649、0.646 和 0.657 时，每组均获得最大 Youden 指数。门诊检查和术前定位组之间获得了可靠的 UGSR 值（ICC=0.79，P=0.68）。
UGSR 是一种简单且可重复的方法，可用于区分 PTMC 和 MNG，因此具有广泛的应用前景。
