Differential diagnosis value of ultrasonic elastography on benign and malignant small thyroid nodules with or without Hashimoto thyroiditis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHAO Haina ,  MA Buyun , LUO Honghao

Department of Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

MA Buyun, Email: ws_mby@126.com

Keywords：

thyroid nodule; Hashimoto thyroiditis; elastography

DOI：

10.7507/1007-9424.201604091

Video：

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Objective To compare differences of characteristics of ultrasonic elasticity imaging for benign and malignant small thyroid nodules with or without Hashimoto thyroiditis (HT). Methods The thyroid nodules with ≤1 cm size and the category 4A, 4B, 4C, and 5 of Thyroid Imaging Reporting and Data System (TI-RADS) were included into this study, and a further examination of real-time elastography was performed. The final diagnosis was relied on the pathological diagnosis. The elasticity score and strain ratio (SR) were recorded and compared between these two groups, respectively. Results Of the 424 nodules, 103 nodules were accompanied with HT (thyroid nodule with HT group), 321 nodules were not accompanied with HT (thyroid nodule without HT group). In the thyroid nodule with HT group, the area under the receiver operator characteristic (ROC) curve (AUCs) of the elasticity score and the SR was 0.685 and 0.676, respectively; the optimal cut offs of the elasticity score and the SR was 3 points and 2.45 respectively, their corresponding sensitivity, specificity, and accuracy was 75.7%, 57.6%, 68.0% and 75.7%, 60.6%, 67.6%, respectively. In the thyroid nodule without HT group, the AUCs of the elasticity score and the SR was 0.692 and 0.692, respectively; the optimal cut offs of the elasticity score and the SR was 4 points and 2.84, respectively; their corresponding sensitivity, specificity, and accuracy was 57.5%, 74.2%, 69.2% and 76.1%, 59.7%, 67.7%, respectively. Conclusions Elastography is helpful in differential diagnosis of benign and malignant small thyroid nodules. While, standards of elasticity score and SR value in differential diagnosis are different between benign and malignant small thyroid nodules with HT and without HT, elasticity score and SR ratio decrease in benign and malignant small thyroid nodules with HT.

Citation： ZHAO Haina, MA Buyun, LUO Honghao. Differential diagnosis value of ultrasonic elastography on benign and malignant small thyroid nodules with or without Hashimoto thyroiditis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(11): 1342-1346. doi: 10.7507/1007-9424.201604091 Copy

1.	Frates MC, Benson CB, Charboneau JW, et al. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement.Radiology, 2005, 237(3): 794-800.
2.	Harach HR, Franssila KO, Wasenius VM. Occult papillary carcinoma of the thyroid. A " normal” finding in Finland. A systematic autopsy study. Cancer, 1985, 56(3): 531-538.
3.	Camargo RY, Tomimori EK. Usefulness of ultrasound in the diagnosis and management of well-differentated thyroid carcinoma. Arq Bras Endecrinol Metabol, 2007, 51(5): 783-792.
4.	李强, 原韶玲, 徐恩伟, 等. 超声弹性成像对桥本氏病甲状腺纤维化程度评估的初步研究. 中华超声影像学杂志, 2014, 23(2): 121-124.
5.	Kwak JY, Han KH, Yoon JH, et al. Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk. Radiology, 2011, 260(3): 892-899.
6.	Ueno E, Ito A. Diagnosis of breast cancer by elasticity imaging (EI). Eizo Joho Medical, 2004, 36(12): 1-6.
7.	郝轶, 柳莉莎. 超声弹性成像技术及其临床应用. 医学综述, 2010, 16(3): 453-455.
8.	Konofagou EE. Quo vadis elasticity imaging? Ultrasonics, 2004, 42(1-9): 331-336.
9.	Ning CP, Jiang SQ, Zhang T, et al. The value of strain ratio in differential diagnosis of thyroid solid nodules. Eur J Radiol, 2012, 81(2): 286-291.
10.	王海玲, 赵利辉, 张晟, 等. 超声弹性成像在甲状腺微小癌诊断中的价值. 中华超声影像学杂志, 2013, 22(1): 88-90.
11.	Wang J, Li P, Sun L, et al. Diagnostic value of strain ratio measurement in differential diagnosis of thyroid nodules coexisted with Hashimoto thyroiditis. Int J Clin Exp Med, 2015, 8(4): 6420-6426.
12.	Dighe M, Luo S, Cuevas C, et al. Efficacy of thyroid ultrasound elastography in differential diagnosis of small thyroid nodules. Eur J Radiol, 2013, 82(6): e274-e280.
13.	于萍, 张万蕾, 于蕾, 等. 超声弹性成像在甲状腺微小病变诊断中的价值. 中国超声医学杂志, 2014, 30(7): 584-587.
14.	张英霞, 武仁. 甲状腺微小癌的常规超声诊断及弹性成像定量参数分析的应用. 内蒙古医科大学学报, 2014, 36(2): 133-137.
15.	何玉霜, 金亚, 马步云, 等. 甲状腺影像报告和数据系统分级结合超声弹性成像对甲状腺结节的诊断效能. 中国普外基础与临床杂志, 2014, 21(9): 1081-1086.
16.	Sherman SI. Thyroid carcinoma. Lancet, 2003, 361(9356): 501-511.
17.	Takashima S, Fukuda H, Nomura N, et al. Thyroid nodules: re-evaluation with ultrasound. J Clin Ultrasound, 1995, 23(3): 179-184.
18.	Rago T, Santini F, Scutari M, et al. Elastography: new developments in ultrasound for predicting malignancy in thyroid nodules. J Clin Endocrinol Metab, 2007, 92(8): 2917-2922.
19.	Cong SZ. Comparison analysis between conventional ultrasonography and ultrasound elastography of thyroid nodules. Eur J Radiol, 2012, 81(8): 1806-1811.
20.	Liang XN, Guo RJ, Li S, et al. Binary logistic regression analysis of solid thyroid nodules imaged by high-frequency ultrasonography, acoustic radiation force impulse, and contrast-enhanced ultrasonography. Eur Rev Med Pharmacol Sci, 2014, 18(23): 3601-3610.
21.	邓伟, 张英霞. 超声弹性应变率比值法评价桥本甲状腺炎合并结节性质的应用价值. 中国临床医学影像杂志, 2014, 25(12): 890-892.
22.	俞清, 王文平, 李超伦, 等. 超声弹性成像技术诊断甲状腺结节的影响因素探讨. 上海医学影像, 2010, 19(3): 165-167.

1. Frates MC, Benson CB, Charboneau JW, et al. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement.Radiology, 2005, 237(3): 794-800.
2. Harach HR, Franssila KO, Wasenius VM. Occult papillary carcinoma of the thyroid. A " normal” finding in Finland. A systematic autopsy study. Cancer, 1985, 56(3): 531-538.
3. Camargo RY, Tomimori EK. Usefulness of ultrasound in the diagnosis and management of well-differentated thyroid carcinoma. Arq Bras Endecrinol Metabol, 2007, 51(5): 783-792.
4. 李强, 原韶玲, 徐恩伟, 等. 超声弹性成像对桥本氏病甲状腺纤维化程度评估的初步研究. 中华超声影像学杂志, 2014, 23(2): 121-124.
5. Kwak JY, Han KH, Yoon JH, et al. Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk. Radiology, 2011, 260(3): 892-899.
6. Ueno E, Ito A. Diagnosis of breast cancer by elasticity imaging (EI). Eizo Joho Medical, 2004, 36(12): 1-6.
7. 郝轶, 柳莉莎. 超声弹性成像技术及其临床应用. 医学综述, 2010, 16(3): 453-455.
8. Konofagou EE. Quo vadis elasticity imaging? Ultrasonics, 2004, 42(1-9): 331-336.
9. Ning CP, Jiang SQ, Zhang T, et al. The value of strain ratio in differential diagnosis of thyroid solid nodules. Eur J Radiol, 2012, 81(2): 286-291.
10. 王海玲, 赵利辉, 张晟, 等. 超声弹性成像在甲状腺微小癌诊断中的价值. 中华超声影像学杂志, 2013, 22(1): 88-90.
11. Wang J, Li P, Sun L, et al. Diagnostic value of strain ratio measurement in differential diagnosis of thyroid nodules coexisted with Hashimoto thyroiditis. Int J Clin Exp Med, 2015, 8(4): 6420-6426.
12. Dighe M, Luo S, Cuevas C, et al. Efficacy of thyroid ultrasound elastography in differential diagnosis of small thyroid nodules. Eur J Radiol, 2013, 82(6): e274-e280.
13. 于萍, 张万蕾, 于蕾, 等. 超声弹性成像在甲状腺微小病变诊断中的价值. 中国超声医学杂志, 2014, 30(7): 584-587.
14. 张英霞, 武仁. 甲状腺微小癌的常规超声诊断及弹性成像定量参数分析的应用. 内蒙古医科大学学报, 2014, 36(2): 133-137.
15. 何玉霜, 金亚, 马步云, 等. 甲状腺影像报告和数据系统分级结合超声弹性成像对甲状腺结节的诊断效能. 中国普外基础与临床杂志, 2014, 21(9): 1081-1086.
16. Sherman SI. Thyroid carcinoma. Lancet, 2003, 361(9356): 501-511.
17. Takashima S, Fukuda H, Nomura N, et al. Thyroid nodules: re-evaluation with ultrasound. J Clin Ultrasound, 1995, 23(3): 179-184.
18. Rago T, Santini F, Scutari M, et al. Elastography: new developments in ultrasound for predicting malignancy in thyroid nodules. J Clin Endocrinol Metab, 2007, 92(8): 2917-2922.
19. Cong SZ. Comparison analysis between conventional ultrasonography and ultrasound elastography of thyroid nodules. Eur J Radiol, 2012, 81(8): 1806-1811.
20. Liang XN, Guo RJ, Li S, et al. Binary logistic regression analysis of solid thyroid nodules imaged by high-frequency ultrasonography, acoustic radiation force impulse, and contrast-enhanced ultrasonography. Eur Rev Med Pharmacol Sci, 2014, 18(23): 3601-3610.
21. 邓伟, 张英霞. 超声弹性应变率比值法评价桥本甲状腺炎合并结节性质的应用价值. 中国临床医学影像杂志, 2014, 25(12): 890-892.
22. 俞清, 王文平, 李超伦, 等. 超声弹性成像技术诊断甲状腺结节的影响因素探讨. 上海医学影像, 2010, 19(3): 165-167.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Differential diagnosis value of ultrasonic elastography on benign and malignant small thyroid nodules with or without Hashimoto thyroiditis

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