Acoustic radiation force impulse imaging in differential diagnosis of small solid thyroid nodules coexisting with Hashimoto's thyroiditis / 中国介入影像与治疗学

ABSTRACT

Objective To investigate the application value of acoustic radiation force impulse imaging (ARFI) in differential diagnosis of small solid thyroid nodules coexisting with Hashimoto's thyroiditis (HT).Methods A total of 136 patients with 155 small solid nodules (≤1 cm in diameter) confirmed by pathology were included.The small solid nodules were divided into HT group and normal group.All patients underwent virtual tissue imaging (VTI) and virtual touch tissue quantification (VTQ).The stiffness of small solid thyroid nodules in two groups was respectively scored based on VTI images,and the area ratios of nodules in VTI images to gray scale images were calculated.Taking pathological diagnosis as the gold standard,the ROC curve were performed to explore the optimal points and efficacy of area ratio and shear wave velocity (SWV) in the diagnosis of malignant nodules in two groups respectively.Results Regarding VTI score≥4 as the diagnostic standard of malignant nodules,the sensitivity of HT group and normal group in diagnosis of malignant nodules had significant difference (64.29％[27/42] vs 81.69％[58/71],P＜0.05).In two groups,the area ratio and SWV of malignant nodules were significantly higher than those of benign nodules (all P＜0.05).The area ratio and SWV of thyroid benign nodules and malignant nodules had no significantly difference between two groups (all P＞0.05).Taking 1.41 as the cutoff point of area ratio,the sensitivity and specificity in diagnosis of malignant nodules in HT group were 85.7％ and 88.9％.Taking 2.87 m/s as the cutoff point of SWV,sensitivity and specificity in diagnosis of malignant nodules in HT group were 85.7％ and 94.4％.Taking 1.40 as the cutoff point of area ratio,the sensitivity and specificity in diagnosis of malignant nodules in normal group were 91.5％ and 95.8％.Taking 2.67 m/s as the cutoff point of SWV,the sensitivity and specificity in diagnosis of malignant nodules in normal group were 88.7％ and 95.8％.Conclusion ARFI technology can evalu-ate the hardness of the small solid thyroid nodules through the intuitive VTI images and objective SWV values in HT,which is helpful in diagnosis of malignant nodules in HT backgroud.