Department of medical ultrasound, Yueyang Central Hospital, Yueyang, China.
Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Endocrinol (Lausanne). 2024 Jan 8;14:1275256. doi: 10.3389/fendo.2023.1275256. eCollection 2023.
This study aims to evaluate the diagnostic performance of quantitative shear wave elastography (SWE) and a new qualitative color pattern SWE for the differentiation of benign and malignant American College of Radiology Thyroid Imaging, Reporting, and Data System (ACR TI-RADS) 4 or 5 category thyroid nodules measuring ≤10 mm.
From May 2020 to July 2022, a total of 237 patients with 270 thyroid nodules were enrolled, and conventional ultrasound and SWE examinations were performed for each patient. Each ACR TI-RADS 4 or 5 category thyroid nodule measuring ≤10 mm was evaluated by quantitative SWE and a new qualitative color pattern SWE. The diagnostic performance of quantitative SWE parameters, the new qualitative color pattern SWE, and the combination of SWE with ACR TI-RADS, respectively, for the differentiation of benign and malignant ACR TI-RADS 4 or 5 category thyroid nodules measuring ≤10 mm was evaluated and compared.
Among 270 thyroid nodules in 237 patients, 72 (26.67%) thyroid nodules were benign and 198 (73.33%) thyroid nodules were malignant. The qualitative color pattern SWE showed better diagnostic performance than the quantitative SWE parameters. When combining the qualitative color pattern SWE with ACR TI-RADS scores, with the optimal cutoff value of the total points ≥8, the thyroid nodules were considered malignant. The sensitivity, specificity, accuracy, and AUC were 89.90%, 56.94%, 81.11%, and 0.820 (95% CI: 0.768-0.864), respectively. Compared with using qualitative color pattern SWE alone, the combination of qualitative color pattern SWE and ACR TI-RADS had better diagnostic performance, which was significantly different ( < 0.05).
The combination of qualitative SWE color patterns and ACR TI-RADS had high sensitivity and accuracy, which might be a convenient and useful method to differentiate benign and malignant ACR TI-RADS 4 or 5 category thyroid nodules measuring ≤10 mm. It would be helpful for the management of thyroid nodules and improving prognosis.
本研究旨在评估定量剪切波弹性成像（SWE）和一种新的定性彩色图案 SWE 在区分美国放射学院甲状腺成像、报告和数据系统（ACR TI-RADS）4 或 5 类直径≤10mm 的甲状腺结节的良恶性方面的诊断性能。
本研究纳入了 2020 年 5 月至 2022 年 7 月期间的 237 名患者，共计 270 个甲状腺结节。对每位患者进行常规超声和 SWE 检查。对每个 ACR TI-RADS 4 或 5 类直径≤10mm 的甲状腺结节进行定量 SWE 和新的定性彩色图案 SWE 评估。分别评估和比较定量 SWE 参数、新的定性彩色图案 SWE 以及 SWE 与 ACR TI-RADS 联合对直径≤10mm 的 ACR TI-RADS 4 或 5 类甲状腺结节的良恶性鉴别诊断的性能。
在 237 名患者的 270 个甲状腺结节中，72 个（26.67%）甲状腺结节为良性，198 个（73.33%）甲状腺结节为恶性。定性彩色图案 SWE 的诊断性能优于定量 SWE 参数。当将定性彩色图案 SWE 与 ACR TI-RADS 评分相结合，最佳总分切点≥8 时，将甲状腺结节视为恶性。其灵敏度、特异度、准确度和 AUC 分别为 89.90%、56.94%、81.11%和 0.820（95%CI：0.768-0.864）。与单独使用定性彩色图案 SWE 相比，定性彩色图案 SWE 与 ACR TI-RADS 联合具有更好的诊断性能，差异具有统计学意义（<0.05）。
定性 SWE 彩色图谱与 ACR TI-RADS 的联合应用具有较高的灵敏度和准确度，可能是一种方便、有效的方法，可用于区分直径≤10mm 的 ACR TI-RADS 4 或 5 类甲状腺结节的良恶性。这有助于甲状腺结节的管理和改善预后。
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