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

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

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.6.777 ◽

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.

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