A threshold value in Shear Wave elastography to rule out malignant thyroid nodules: A reality?
A threshold value in Shear Wave elastography to rule out malignant thyroid nodules: A reality?
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DOI：
10.1016/j.ejrad.2012.09.002
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发表时间：
2012-12-01
影响因子：
3.3
通讯作者：
Petit, P.
中科院分区：
文献类型：
--
作者：
Veyrieres, J-B.;Albarel, F.;Petit, P.
目的：为了评价ShearWave（TM）弹性成像阈值排除恶性甲状腺结节的能力，同时研究其与形态学征象的相关性。15.8）转诊进行甲状腺结节手术，接受标准超声和弹性成像。计算与组织学相关的形态学体征和最大弹性成像指数的特征。还评价了形态学体征与弹性成像的相关性。结果：共研究了297个结节。发现35种癌症（11.6%）。恶性结节的弹性成像指数（115 kPa 60.4）高于良性结节（41 kPa 25.8）（p < 0.001，Student's t检验）。临界值66 kPa是区分恶性结节的最佳值，敏感性为80%（CI 95%，62.5; 90.9），特异性为90.5%（CI 95%，86.1; 93.6）（p = 0.0001）。弹性成像和形态学超声体征的相关性显示灵敏度为97%（CI 95%，83.3; 99.8），阴性预测值为99.5%（CI 95%，95.6; 99.9）。观察者间的重复性良好，组间相关系数为0.97（CI 95%，0.96; 0.98）（p < 0.001）。结论：66 kPa阈值是排除恶性甲状腺结节的最佳超声征象。该方法简便、定量、重现性好，可用于大于3 cm结节的研究。钙化结节和滤泡性肿瘤的研究仍需取得进展。(C)2012爱思唯尔爱尔兰有限公司保留所有权利。
Objectives: To evaluate hability of a threshold value in ShearWave(TM) elastography to rule out malignant thyroid nodules while studying its pertinence in association with morphological signs.Equipment and methods: 148 patients (110 women and 38 men; 52.5 y.o. 15.8) referred for surgery of thyroid nodules underwent standard ultrasound as well as elastography. Characteristics of the morphological signs and maximum elastographic index were calculated in relation to histology. Association of morphological signs alone and then of elastography was also evaluated. One hundred and fifty one nodules were studied on a double-blind basis.Results: 297 nodules were studied. Thirty-five cancers were detected (11.6%). Elastographic index was higher in malignant nodules (115 kPa 60.4) than in benign nodules (41 kPa 25.8) (p < 0.001, Student's t-test). Cut off value of 66 kPa was the best to discriminate malignant nodules with a sensitivity of 80% (CI 95%, 62.5; 90.9) and a specificity of 90.5% (CI 95%, 86.1; 93.6) (p = 0.0001). Association of elastography and morphological ultrasound signs presented a sensitivity of 97% (CI 95%, 83.3; 99.8) and a negative predictive value of 99.5% (CI 95%, 95.6; 99.9). Interobserver reproducibility proved to be excellent with an interclass correlation of 0.97 (CI 95%, 0.96; 0.98) (p < 0.001).Conclusion: The 66 kPa threshold in Shear Wave elastography is the best ultrasound sign to rule out malignant thyroid nodules. The method is simple, quantitative, reproducible and usable in the study of nodules larger than 3 cm. Progress must still be made in the study of calcified nodules and follicular tumors. (C) 2012 Elsevier Ireland Ltd. All rights reserved.