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.
ObjectiveTo study the Young's modulus obtained by the real-time shear wave elastography (SWE) in healthy adults' parotid gland and submaxillary gland and to explore the probable factors affecting the Young's modulus, such as bilateral parotid and submaxillary gland, sex, age, height and weight. MethodsThere were 35 healthy volunteers who underwent SWE in parotid gland and submaxillary gland between December 3 and 18, 2013. The difference of Young's modulus in bilateral parotid and submaxillary gland, and the modulus values of different sex, age, height and weight groups were also compared. ResultsThe Young's modulus of parotid gland was (8.14±1.78) kPa, and the Young's modulus of submaxillary gland was (11.52±2.34) kPa. The differences of Young's modulus between the two sides of parotid gland and submaxillary gland were not statistically significant (P>0.05); the differences of Young's modulus of parotid and submaxillary gland between different sex, age, height and weight groups had no statistical significance, either (P>0.05). ConclusionThe real-time shear wave elastography can be applied to evaluate the elasticity of parotid and submaxillary gland and to lay the foundation for further diagnosis of salivary lesions.
Objective To evaluate the diagnostic performance of thyroid imaging reporting and data system (TI-RADS)classification and elastography in differentiating benign and malignant thyroid nodules according to size. Methods A total of 222 thyroid nodules (209 cases) with solid or predominantly solid internal contentdiagnosed at pathological findings were enrolled in this study, all the 209 cases underwent surgery in our hospital from Jan.2014 to Jun.2014. The diagnostic performance of TI-RADS classification and elastography in differentiating benign and malignant thyroid nodules according to size nodules were evaluated (for≤1 cm and > 1 cm respectively). Results By using TI-RADS category and elastography, 178 thyroid nodules were diagnosed as malignant nodules, and 44 thyroid nodules were diagnosed as benign nodules. The high predictive factors for malignant thyroid nodules of > 1 cm were irregular shape(OR=6.376), microcalcification(OR=21.525), and capsule invasion(OR=3.852), P < 0.05. The factors for thyroid nodules of≤1 cm were anteroposterior to transverse diameter ratio≥1(OR=3.406), capsule invasion (OR=3.922), and high elastography score(OR=1.606), that suggested the possibility of malignant (P < 0.05). For nodules of > 1 cm, the sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and Youden index of TI-RADS combining with elastography were 98.3%(59/60), 68.6%(24/35), 87.4%(83/95), 84.3%(59/70), 96.0% (24/25), and 66.9% respectively; for nodules of≤1 cm, the sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and Youden index were 98.5%(67/68), 30.5%(18/59), 66.9%(85/127), 62.0%(67/108), 94.7%(18/19), and 29.0% respectively. Conclusion TI-RADS category combined with elastography for diagnosis of thyroid nodules in different size has just a bit differently diagnostic indicators, but that play a high diagnostic performance on the thyroid nodules with maximum diameter > 1 cm.
ObjectiveTo establish logistic regression analysis model to evaluate the diagnostic efficacy of breast imaging report and data system (BI-RADS) ultrasound signs in forecasting malignant risk of breast lesions. MethodUltrasound graphic materials of 1 660 breast lesions diagnosed during January to September 2011 were retrospectively studied and standardized by BI-RADS. Pathology results were regarded as gold standard reference. Ultrasound signs with significant efficacy after single-factor logistic regression were evaluated in multi-factor logistic regression model to predict the malignant risk of breast lesions. ResultsEighteen ultrasound signs of breast lesions on BI-RADS were included in the final regression model. Among them, Cooper ligaments stretch, echogenic halo, skin thickening, axillary lymph node abnormalities, structural distortions and speculation had high OR values of 30 or more and had higher specificity than 90%. The diagnosis values of regressions model were high, with a sensitivity of 84.5%, specificity 95.5% and accuracy 91.4%. The area under ROC curve was 0.964 and prediction accuracy was 91.0%. ConclusionsThe logistic regression model based on BI-RADS ultrasound signs of breast lesions has high diagnostic values in detecting breast cancer.
The sonographic features of male breast lesions, which underwent ultrasound examination in our hospital for the past 10 years, were retrospectively analyzed. Sonographic features of these lesions were standardized as BI-RADS image lexicon. The differences in ultrasonic malignant signs were assessed between the benign and the malignant diseases. Between the two groups, incomplete boundary was statistically different. The specificity was above 95% within the two groups in terms of speculated margin, echogenic halo, calcification, axillary lymphadenopathy, thickening of skin and eccentric of mass to the nipple. High-frequency sonographic examination has a high level of differential diagnosis for male breast lesions.