Application value of ultrasound elasticity index ratio and elasticity index methods in differential diagnosis of benign and malignant thyroid nodules / 中华地方病学杂志

ABSTRACT

Objective To explore the application value of ultrasound elasticity index ratio and elasticity index methods in differential diagnosis of different sizes of benign and malignant thyroid nodules.Methods Clinical examination data of patients who were hospitalized for thyroid nodules were collected and were retrospectively analyzed in the Fourth Affiliated Hospital of Harbin Medical University from January 2015 to January 2016.The elasticity index ratio and elasticity index were used to diagnose benign and malignant thyroid nodules,and the results were compared with pathological diagnosis.The thyroid nodules were fell into three groups according to the maximum long diameter＜ 1,1-2,and ＞ 2 cm.Using the above two methods,the sensitivity,specificity and accuracy were analyzed in benign and malignant thyroid nodules with different sizes.And the receiver operating characteristic curve (ROC) was drawn.Results A total of 90 patients (108 nodules) were enrolled in the study and they were from thyroid nodular surgery,28 male cases,62 female cases,mean age (44.1 ± 11.5) years,and ranged from 20 to 69 years old.Seventy benign nodules and 38 malignant nodules were diagnosed with pathology.Sixtythree benign nodules and 45 malignant nodules were diagnosed via the ultrasound elasticity index ratio method.Compared with the pathological diagnosis,13 were misdiagnosed and 6 were omission diagnosed in malignant thyroid nodules.Sixty-three benign nodules and 45 malignant nodules were diagnosed via the ultrasound elasticity index method.Compared with the pathological diagnosis,16 were misdiagnosed and 9 were omission diagnosed in malignant thyroid nodules.Sensitivities of elasticity index ratio method in ＜ 1,1-2,and ＞ 2 cm groups were 91.7％,86.0％,and 75.0％;specificities were 88.9％,78.6％,and 79.2％,and accuracies were 90.0％,81.0％,and 77.8％;and differences in sensitivity and accuracy of the two methods were statistically significant (x2 =76.4,70.8,P ＜ 0.05).Sensitivities of elasticity index method in ＜ 1,1-2,and ＞ 2 cm were 83.3％,78.6％,and 66.7％;specificities were 83.3％,75.0％,and 75.0％,and accuracies were 83.3％,76.0％,and 72.2％.Differences in sensitivity and accuracy of the two methods were statistically significant (x2 =82.8,74.5,P ＜ 0.05).The area under the ROC curve of elasticity index ratio and of elasticity index was 0.814 and 0.766,respectively,and the difference was statistically significant (Z =0.896.P ＜ 0.05).Conclusions In the differential diagnosis of different sizes of benign and malignant thyroid nodules,the elasticity index ratio method is better than the elasticity index method.The diagnostic value on ≤ 2 cm nodules is higher.