scholarly journals Ultrasonic elastography and conventional ultrasound in the diagnosis of thyroid micro-nodules

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Jinming Wang ◽  
Wenbing Wei ◽  
Rui Guo
Keyword(s):  
Differential Diagnosis ◽  
Roc Curve ◽  
Thyroid Nodules ◽  
Ultrasound Elastography ◽  
Surgical Pathology ◽  
Maximum Diameter ◽  
Clinical Value ◽  
Conventional Ultrasound ◽  
Missed Diagnosis ◽  
The Difference

Objective: To investigate the clinical value of conventional ultrasound, ultrasound elastography and conventional ultrasound combined with ultrasound elastography in differential diagnosis of benign and malignant thyroid micro-nodules. Methods: Eighty-six patients who were found with thyroid micro-nodules with the maximum diameter no more than 10 mm in the physical examination in our hospital from June 2015 to December 2017 were selected, and 102 nodules were included. All patients were confirmed with thyroid micro-nodules by puncture or surgical pathology and underwent conventional ultrasound and ultrasound elastography. Taking the surgical pathological results as a control, the value of conventional ultrasound, ultrasound elastography and conventional ultrasound combined with ultrasound elastography in differential diagnosis of benign and malignant thyroid micro-nodules were compared. A receiver operating characteristic (ROC) curve was drawn, and the area under the ROC curve was calculated. Results: One hundred and two thyroid nodules were detected by surgical pathology, including 75 benign nodules (73.53%) and 27 malignant nodules (26.47%). The sensitivity and diagnostic accordance rate of ultrasound elastography were significantly higher than those of conventional ultrasound in the diagnosis of thyroid microcarcinoma, and the missed diagnosis rate of ultrasound elastography was significantly lower than that of conventional ultrasound; the difference was statistically significant (P<0.05). However, the difference between the two methods was not statistically significant in terms of diagnostic specificity and misdiagnosis rate (P>0.05). The areas under the ROC curve in the diagnosis of benign and malignant thyroid nodules by conventional ultrasound and ultrasound elastography were 0.735 and 0.743 respectively. Conclusion: Conventional ultrasound can be used as a routine examination technique in differential diagnosis of benign and malignant thyroid nodules, while ultrasound elastography can improve the sensitivity and diagnostic rate in the diagnosis of thyroid micro carcinoma. It can help to reduce the clinical missed diagnosis, which also can be be used as an effective supplement for conventional ultrasound. doi: https://doi.org/10.12669/pjms.35.6.777 How to cite this:Wang J, Wei W, Guo R. Ultrasonic elastography and conventional ultrasound in the diagnosis of thyroid micro-nodules. Pak J Med Sci. 2019;35(6):1526-1531. doi: https://doi.org/10.12669/pjms.35.6.777 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Ultrasound Elastography Using Carotid Artery Pulsation in the Differential Diagnosis of Sonographically Indeterminate Thyroid Nodules

2015 ◽  
Vol 204 (2) ◽  
pp. 396-401 ◽  
Author(s):  
Woo Jung Choi ◽  
Jeong Seon Park ◽  
Hye Ryoung Koo ◽  
Soo-Yeon Kim ◽  
Min Sung Chung ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Carotid Artery ◽  
Thyroid Nodules ◽  
Ultrasound Elastography

Ultrasonographic Multimodality Diagnostic Model of Thyroid Nodules

2018 ◽  
Vol 41 (2) ◽  
pp. 63-77
Author(s):  
Rui-na Zhao ◽  
Bo Zhang ◽  
Yu-xin Jiang ◽  
Xiao Yang ◽  
Xing-jian Lai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Flow ◽  
Thyroid Cancer ◽  
Thyroid Nodules ◽  
Flow Distribution ◽  
Ultrasound Elastography ◽  
Diagnostic Model ◽  
Blood Flow Distribution ◽  
Conventional Ultrasound ◽  
Independent Risk Factors

The aim of this study was to identify independent risk factors for thyroid cancer, establish an ultrasonographic multimodality diagnostic model for thyroid nodules, and explore the diagnostic value of the model. From November 2011 to February 2015, 307 patients with a total of 367 thyroid nodules underwent conventional ultrasound, contrast-enhanced ultrasound (CEUS), and ultrasound elastography examinations before surgery. A binary logistic regression analysis was performed to identify independent risk factors for thyroid cancer and to establish a multimodality diagnostic model for thyroid nodules. The diagnostic performance of conventional ultrasound, CEUS, ultrasound elastography, and the multimodality diagnostic model was assessed and compared. The following seven independent risk factors were included in the logistic regression models: age, irregular shape, hypoechoic pattern, marked hypoechoic pattern, irregular blood flow distribution, heterogeneous enhancement, and an elastic score of 3/4. The multimodality diagnostic model had a diagnostic accuracy of 86.9%, with a sensitivity of 93.5% and a specificity of 77.3%. The multimodality diagnostic model improved the diagnostic accuracy compared with that of conventional ultrasound, CEUS, and ultrasound elastography. Independent risk factors for thyroid cancer included age, irregular shape, hypoechoic pattern, marked hypoechoic pattern, irregular blood flow distribution, heterogeneous enhancement, and an elastic score of 3/4. The multimodality diagnostic model was demonstrated to be effective in the diagnosis of thyroid nodules.

scholarly journals Diagnostic Efficacy of Ultrasound, Cytology, and BRAFV600E Mutation Analysis and Their Combined Use in Thyroid Nodule Screening for Papillary Thyroid Microcarcinoma

2022 ◽  
Vol 11 ◽  
Author(s):  
Jing Du ◽  
Ruijun Han ◽  
Cui Chen ◽  
Xiaowei Ma ◽  
Yuling Shen ◽  
...  
Keyword(s):  
Mutation Analysis ◽  
Roc Curve ◽  
Thyroid Nodules ◽  
Papillary Thyroid Microcarcinoma ◽  
Maximum Diameter ◽  
Diagnostic Efficiency ◽  
Papillary Thyroid ◽  
Diagnostic Efficacy ◽  
Thyroid Microcarcinoma ◽  
Combined Use

BackgroundUltrasound, cytology, and BRAFV600E mutation analysis were applied as valuable tools in the differential diagnosis of thyroid nodules. The aim of the present study was to evaluate the diagnostic efficiency of the three methods and their combined use in screening for papillary thyroid microcarcinoma (PTMC).MethodsA total of 1,081 patients with 1,157 thyroid nodules (0.5–1 cm in maximum diameter) classified as thyroid imaging reporting and data system (TIRADS) 4–5 were recruited. All patients underwent ultrasound, fine-needle aspiration (FNA) examination, and an additional BRAFV600E mutation test. TIRADS and Bethesda System for Reporting Thyroid Cytopathology (BSRTC) were adopted to judge the ultrasound and cytological results. The receiver operating characteristic (ROC) curve was established to assess the diagnostic values of different methods.ResultsOf the 1,157 nodules, 587 were benign and 570 were PTMCs. BRAFV600E mutation test had highest sensitivity (85.4%), specificity (97.1%), accuracy (91.4%), and area under the ROC curve (Az) value (0.913) among the three methods. The combination of BSRTC and BRAFV600E mutation analysis yielded a considerably high sensitivity (96.0%), accuracy (94.3%), and negative predictive value (95.9%) than either BSRTC or BRAFV600E mutation alone (P &lt; 0.0001 for all comparisons). Of all the methods, the combined use of the three methods produced the best diagnostic performance (Az = 0.967), which was significantly higher than that (Az = 0.943) for the combination of BSRTC and BRAFV600E mutation (P &lt; 0.0001). The diagnostic accuracy of the molecular method in the 121 nodules with indeterminate cytology was 90.1% (109/121), which was significantly higher than that of TIRADS classification, 74.4% (90/121) (P = 0.002).ConclusionThe combined use of ultrasound, cytology, and BRAFV600E mutation analysis is the most efficient and objective method for diagnosing PTMC. Both BRAFV600E mutation and TIRADS classification are potentially useful adjuncts to differentiate thyroid nodules, especially indeterminate samples classified as BSRTC III.

Ultrasound Elastography in Differential Diagnosis of Benign and Malignant Thyroid Nodules

2010 ◽  
Vol 10 (4) ◽  
pp. 229
Author(s):  
Ki Young Kim ◽  
Jin Woo Cha ◽  
Seok Ho Choi ◽  
Chang Gyu Byun ◽  
Young Taek Koh ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Thyroid Nodules ◽  
Ultrasound Elastography

Analysis of the Influence Factors on the Differential Diagnosis Between Benign and Malignant 4-Class Thyroid Nodules by the Ratio of the Elastic Strain Rate

2020 ◽  
Vol 10 (3) ◽  
pp. 731-735
Author(s):  
Peng An ◽  
Yingjian Ye ◽  
Yuxin Ning ◽  
Wei Feng ◽  
Yang Li ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Thyroid Gland ◽  
Strain Rate ◽  
Roc Curve ◽  
Elastic Strain ◽  
Operating Characteristic ◽  
Thyroid Nodules ◽  
Influence Factors ◽  
Factors Influencing ◽  
Surgical Operations

Objective: This study aimed to investigate the value of elastic strain rate ratio (SR) in the differential diagnosis of benign and malignant thyroid imaging reporting and data system (TI-RADS) 4 nodules under the influence of various factors. Method: This study included 180 patients with type 4 unifocal thyroid nodules diagnosed by ultrasound examination in the Xiangyang No. 1 People's Hospital from March 2016 to March 2019. All patients underwent elasticity imaging and surgical operations. The pathological results were used as the gold standard to perform logistic regression analyses and identify the factors influencing the differential diagnosis of benign and malignant thyroid nodules. Then, the receiver operating characteristic (ROC) curve was drawn. Results: The ROC curve suggested a cutoff value of 0.52 in differentiating between benign and malignant TI-RADS 4 nodules using the SR value. The nodule size, calcification, border, and thyroid gland with diffuse lesions were factors influencing the differential diagnosis of benign and malignant TI-RADS 4 nodules with the SR value. SR had a high accuracy identifying benign and malignant TI-RADS 4 nodules with a diameter of less than 0.8 cm (but >0.4 cm), no or granular calcification, nodules with blurred borders, and no thyroid gland with diffuse lesions. Conclusion: The diagnostic accuracy was improved by combining the two-dimensional ultrasound with SR determination in the differential diagnosis of benign or malignant TI-RADS 4 nodules.

scholarly journals Efficacy of Differential Diagnosis of Thyroid Nodules by Shear Wave Elastography, the Stiffness Map

2021 ◽  
Author(s):  
Myung Hi Yoo ◽  
Hye Jeong Kim ◽  
In Ho Choi ◽  
Suyeon Park ◽  
Sumi Yun ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Shear Wave ◽  
Roc Curve ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Curve Analysis ◽  
Follicular Neoplasm ◽  
Roc Curve Analysis ◽  
Cutoff Value ◽  
Benign Pathology

Abstract Background Fine-needle aspiration is the gold standard, but malignancy rate of the indeterminate cytology is reported as 20-50 %. We aimed to evaluate the efficacy of shear wave elastography (SWE) added to ultrasonogram in the differential diagnosis of thyroid nodules. Methods We retrospectively reviewed the medical records of 258 consecutive patients. Thyroid nodules were divided in to 4 categoies according to maximum elasticity (EMax) and nodule depth/width (D/W) ratio; Category 1 (EMax ≥42.6 kPa & D/W&lt;0.9), Category 2 (EMax &lt;42.6 kPa & D/W&lt;0.9 ), Category 3 (EMax ≥42.6 kPa & D/W≥ 0.9) and Category 4 (EMax&lt;46.2 kPa & D/W≥ 0.9 ). The cutoff value of EMax was set using ROC curve analysis to predict nodular hyperplasia (NH) from follicular neoplasm (FN). Cutoff value ​​for nodule D/W ratio was set using ROC curve analysis for malignancy. Results NH was the most prevalent pathology group in category 1, FN in category 2 and PTC in category 3. The category 3 demonstrated the highest rate of malignancy (81.8%) and had 55.4% sensitivity and 90% specificity for predicting malignancy. When assessing the benign pathology of NH in follicular patterned lesion, category 1 demonstrated the highest NH prevalence of 88.9% (34/37) and had 73.9% sensitivity and 85.0% specificity. Conclusion The performance for malignancy was highest in category 3 and predictive ability for benign pathology of NH in follicular lesion was highest in category 1. So the information of EMax and nodule D/W ratio was useful to predict the pathology of thyroid nodules

scholarly journals Is Contrast-Enhanced Ultrasound Superior to Computed Tomography for Differential Diagnosis of Gallbladder Polyps? A Cross-Sectional Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Zhiqing Yuan ◽  
Xuesong Liu ◽  
Qiwei Li ◽  
Yunhe Zhang ◽  
Ling Zhao ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Perfusion Defect ◽  
Diagnostic Methods ◽  
Maximum Diameter ◽  
Clinical Value ◽  
Diagnostic Efficacy ◽  
Cross Sectional ◽  
Gallbladder Polyps ◽  
Contrast Enhanced

ObjectiveTo compare the clinical value of contrast-enhanced ultrasonography (CEUS) versus computed tomography (CT) for distinguishing neoplastic and non-neoplastic gallbladder polyps. Given whether laparoscopic cholecystectomy is needed, differential diagnosis of neoplastic and non-neoplastic gallbladder polyps is more important than benign and malignant polyps.MethodsA total of 89 consecutive patients with polypoid lesions of the gallbladder &gt; 10 mm in size without local invasion or distant metastasis during primary screening were enrolled in this prospective and comparative study. All patients who met the inclusion criteria underwent CEUS and CT examinations prior to surgical resection. The enhancement patterns and microvascular imaging types were analyzed on CEUS. The maximum diameter and CT value of the lesions were also recorded and subjected to a comparative analysis. The clinical value of the two diagnostic methods is compared.ResultsOf the 89 patients, there were 58 (65.2%) cases of non-neoplastic polyps and 31 (34.8%) cases of neoplastic polyps. The average diameter of neoplastic polyps was significantly higher than that of non-neoplastic polyps (P&lt;0.001). The detection rate using CEUS was 100%. The proportion of perceived non-neoplastic polyps in the nonenhanced and arterial phases were 48.3% and 77.6%, respectively, which were significantly lower than those of neoplastic polyps (93.5%, P&lt;0.001 and 100.0%, P&lt;0.001, respectively). However, in the venous and delayed phases, all cholesterol polyps and neoplastic polyps were perceived. CT showed that non-neoplastic polyps exhibited delayed enhancement. On CEUS 29.0% neoplastic polyps showed a perfusion defect, whereas 6.9% non-neoplastic polyps showed a perfusion defect (P=0.005). The microvascular architecture of the lesions on CEUS was categorized into 4 types: spotty, linear, branched, and spinous, and there were significant differences between the two groups (P&lt;0.001). The sensitivities and specificities were 87.10% and 68.97% for CEUS and 83.87% and 77.59% for CT, respectively (P=0.406).ConclusionsCEUS and CT are useful for differential diagnosis of neoplastic and nonneoplastic polypoid lesions of the gallbladder. Diagnostic efficacy was comparable between CEUS and CT. Thus, CEUS is preferred over CT in the differential diagnosis of neoplastic and non-neoplastic gallbladder polyps due to its comparable diagnostic efficacy and lack of radiation dose.

scholarly journals Clinical value of SMI Combined with Low-Dose CT Scanning in differential diagnosis of Thyroid Lesions and Tumor Staging

2021 ◽  
Vol 37 (5) ◽  
Author(s):  
Shao-wei Xue ◽  
Yu-kun Luo ◽  
Zi-yu Jiao ◽  
Lin Xu
Keyword(s):  
Differential Diagnosis ◽  
Low Dose ◽  
Tumor Staging ◽  
Ct Scanning ◽  
Correlation Property ◽  
Coincidence Rate ◽  
Clinical Value ◽  
Low Dose Ct ◽  
The Difference ◽  
Thyroid Lesions

Objectives: To investigate the clinical value of Superb Microvascular Imaging (SMI) combined with low dose CT scanning in differential diagnosis of thyroid lesions and tumor staging. Methods: A total of 120 patients with thyroid nodules admitted to the Chinese PLA General Hospital from January 2017 to July 2020 were selected. Paired design was adopted in this study. SMI and SMI combined with low-dose CT scanning were respectively carried out to these patients. The results were judged by two senior imaging physicians and two senior sonographers respectively. And t-test, χ2 test, Pearson correlation coefficient check and other methods were adopted to comparatively analyze the above two methods and the pathological results after operation or puncture. Results: Compared with pathologic findings, the coincidence rate of SMI was 40%, and the coincidence rate of SMI combined with low dose CT scanning was 84%. The difference was significant (p=0.00); among the 120 thyroid nodule patients, 50 were diagnosed as malignant by pathological diagnosis, and 70 as benign; 27 malignant cases and 93 benign cases were detected by SMI; 48 malignant cases and 72 benign cases were detected by SMI combined with low dose CT scanning. The sensitivity and accuracy of the latter were significantly higher than those of the former, and the difference was statistically significant (p=0.00); the enhancement, edge sharpness and homogeneity of SMI increased with the increase of tumor malignancy, showing positive correlation property. Conclusion: SMI combined with low dose CT scanning has a higher diagnostic coincidence rate. Its sensitivity and accuracy are significantly superior. With the increase of tumor malignancy, the enhancement and unhomogeneity of SMI increase, and the edge is more blurred. That suggests: with the increase of tumor malignancy, neovascularization in the tumor is more obvious and more unevenly distributed; the increase of edge blur indicates more obvious tumor infiltration. The method has considerable clinical value for predicting the malignancy of tumors. doi: https://doi.org/10.12669/pjms.37.5.4144 How to cite this:Xue SW, Luo YK, Jiao ZY, Xu L. Clinical value of SMI Combined with Low-Dose CT Scanning in differential diagnosis of Thyroid Lesions and Tumor Staging. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4144 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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