Interobserver Agreement and Intraobserver Reproducibility in Thyroid Ultrasound Elastography
Interobserver Agreement and Intraobserver Reproducibility in Thyroid Ultrasound Elastography
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DOI：
10.2214/ajr.11.7009
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发表时间：
2012-04-01
影响因子：
5
通讯作者：
Kim, Yongmin
中科院分区：
文献类型：
--
作者：
Lim, Dong-Jun;Luo, Si;Kim, Yongmin
OBJECTIVE.本研究的目的是评估甲状腺超声弹性成像的观察者间一致性和观察者内的重复性。2010年12月至2011年3月期间，本前瞻性研究入组了五十六例患者（56个结节）。所有患者均安排甲状腺手术，因为细针穿刺活检发现其结节为恶性、疑似恶性或滤泡/Hurthle细胞肿瘤。对每名患者，三名内分泌学家进行超声弹性成像检查使用商业超声机。由于使用的是颈动脉搏动，因此未使用换能器进行外部压迫。每位内分泌学家对同一甲状腺结节重复进行弹性成像检查。一个弹性对比指数，它量化了结节内的局部应变对比，结节的边界划定后，由内分泌学家交互确定。大的弹性对比指数值表明结节恶性的可能性增加。Pearson相关系数用于评价观察者间和观察者内测量的弹性对比指数值的一致性，p值< 0.05被认为具有统计学意义。在甲状腺超声弹性成像中发现了观察者间和观察者内的显著一致性。两名观察员之间的Pearson相关系数分别为0.79（观察员1和2，p < 0.01）、0.77（观察员1和3，p < 0.01）和0.73（观察员2和3，p < 0.01）。观察者1、2和3的观察者内一致性的Pearson相关系数分别为0.87（p <0.01）、0.73（p <0.01）和0.84（p < 0.01）。甲状腺超声弹性成像具有良好的观察者间和观察者内一致性。通过与体外弹性成像比较，我们发现甲状腺内压弹性成像可以产生可靠的结果。
OBJECTIVE. The objective of this study was to evaluate interobserver agreement and intraobserver reproducibility in thyroid ultrasound elastography.SUBJECTS AND METHODS. Fifty-six patients (56 nodules) were enrolled for this prospective study between December 2010 and March 2011. All patients were scheduled for thyroid surgery because their nodules had been found by fine-needle aspiration biopsies to be malignant, suspicious for malignancy, or follicular/Hurthle cell neoplasm. On each patient, three endocrinologists performed ultrasound elastography examinations using a commercial ultrasound machine. No external compression with the transducer was applied because pulsation from the carotid artery was used. Each endocrinologist repeated an elastography examination on the same thyroid nodule. An elasticity contrast index, which quantifies the local strain contrast within a nodule, was interactively determined after a nodule's boundary was delineated by the endocrinologist. A large elasticity contrast index value indicates an increased probability of the nodule being malignant. Pearson correlation coefficient was used to evaluate the interobserver and intraobserver agreement in the measured elasticity contrast index values, and p values < 0.05 were considered statistically significant.RESULTS. Significant interobserver and intraobserver agreement was found in thyroid ultrasound elastography. Pearson correlation coefficients between two observers were 0.79 (observers 1 and 2, p < 0.01), 0.77 (observers 1 and 3, p < 0.01), and 0.73 (observers 2 and 3, p < 0.01). Pearson correlation coefficients for intraobserver agreement were 0.87 (p < 0.01), 0.73 (p < 0.01), and 0.84 (p < 0.01) for observers 1, 2 and 3, respectively.CONCLUSION. Good interobserver and intraobserver agreement exists in thyroid ultrasound elastography. Compared with external compression elastography, we found that thyroid elastography with intrinsic compression can produce reliable results.