Shear wave elastography and acoustic radiation force impulse imaging in differential diagnosis of benign and malignant thyroid nodules / 中国介入影像与治疗学

ABSTRACT

Objective To compare the diagnostic value of shear wave elastography (SWE) and acoustic radiation force impulse imaging (ARFI) in benign and malignant thyroid nodules (TNs).Methods A total of 43 patients with 51 thyroid nodules were included.According to the diameter,all nodules were divided into small nodules (diameter ≤1 cm) and large nodules (1 cm＜diameter≤3 cm).All patients underwent both SWE and ARFI examinations at the same time.SWE (Emax,Emean,Emin),virtual touch tissue quantification (VTQ) and virtual touch tissue imaging (VTI) area ratio were obtained.The optimal cut-off values of SWE,VTQ,VTI area ratio were calculated with ROC curve to identify malignant thyroid nodules from benign ones,and the sensitivity,specificity,accuracy of Emax,VTQ and VTI area ratio were calculated respectively.Results The cut-off value of Emax,VTQ,VTI area ratio in differential diagnosis of benign and malignant TNs was 37.74 kPa,2.19 m/s and 1.24,respectively.The sensitivity was 85.30％ (29/34),76.50％ (26/ 34),64.71％ (22/34),the specificity was 100％ (17/17),94.10％ (16/17),88.20％ (15/17),the accuracy was 90.20％ (46/51),90.20％ (46/51),72.55％ (37/51) of E VTQ and VTI area ratio in diagnosis of malignant thyroid nodules,respectively.The sensitivity of Emax and VTQ in the diagnosis of malignant large NTs was 92.31％ (12/13) and 100％ (13/13),respectively,while the sensitivity of VTI area ratio and Emax in the diagnosis of malignant small NTs were both 80.95％ (17/21).Conclusion Either SWE or ARFI has good diagnostic performance in distinguishing malignant thyroid nodules from benign ones.Emax is of equal value in diagnosing thyroid benign and malignant nodules.VTQ has advantage for diagnosing large NTs,while VTI area ratio shows better diagnostic performance for small NTs.