Diagnositic value of contrast-enhanced ultrasound and ultrasound elastography in thyroid nodules (TI-RADS 4) with indeterminate cytology

doi:10.3877/cma.j.issn.1672-6448.2019.03.013

Abstract

Abstract:

Objective

To ivestigate the clinical value of ultrasound elastography in combination with contrast-enhanced ultrasound in nondiagonostic thyroid nodules with suspicous ultrasound features.

Methods

A total of 140 patients with 151 thyroid nodules (TIRADS 4) were examined by elastography and contrast-enhanced ultrasound (CEUS) in this study. The results were compared with surgical pathology. According to the maximal diameter of thyroid nodules, they were divided into group A (≤1.0 cm) and group B (>1.0 cm). Surgical pathologic results as the ″gold standard″, through four tables calculated the sensitivity, specificity and accuracy of the elastography, CEUS and combining both diagnosis. The sensitivity, specificity and accuracy were analyzed by chi-square test.

Results

The sensitivity, specificity, accuracy of CEUS combined with elastography were 98.0%, 89.0%, 93.7% in group A, while in group B, they were 96.8%, 88.0%, 92.9%. In group A, the differeces in sensitivity and accuracy were statistically significant (χ²=17.344, 16.315, all P<0.001); the sensitivity and accuracy of combined were higher than those of CEUS (χ²=17.344, 16.173, P<0.001); The sensitivity and accuracy of combined were higher than those of elastography (χ²=7.111, 5.141, P均<0.05). In group B, the differeces in sensitivity and accuracy were statistically significant (χ²=15.123, 15.485, all P<0.01) the sensitivity and accuracy of combined were higher than those of CEUS (χ²=5.167, 3.903, P均<0.05); The sensitivity and accuracy of combined were higher than those of elastography (χ²=14.862, 14.882, P<0.001). The accuracy of CEUS is higher than elastography in group B (χ²=4.375, P=0.036). The sensitivity and accuracy of elastography in group A were higher those in group B (χ²=6.943, 8.127, P均<0.01). The above differences were statistically significant (all P<0.05).

Conclusions

Combination of CEUS with ultrasound elastography have good application value in diagnosis of thyroid nodules with indeterminate cytology. And elastography has a higher diagnostic value for thyroid nodules in group A than in group B.

Key words: Contrast-enhanced ultrasound, Ultrasound elastography, Fine needle aspiration cytology

Aimei Lu, Pintong Huang, Yurong Hong, Chao Zhang, Jieli Luo. Diagnositic value of contrast-enhanced ultrasound and ultrasound elastography in thyroid nodules (TI-RADS 4) with indeterminate cytology[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2019, 16(03): 226-231.

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Figures/Tables 7

References 15

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检查方法	敏感度	特异度	准确性
超声造影	66.0^a	77.8	71.6^b
弹性成像	82.0^c	84.4	83.2^d
联合	98.0	89.0	93.7
χ²值	17.344	2.064	16.315
P值	0.000	0.356	0.000

检查方法	敏感度	特异度	准确性
超声造影	66.0^a	77.8	71.6^b
弹性成像	82.0^c	84.4	83.2^d
联合	98.0	89.0	93.7
χ²值	17.344	2.064	16.315
P值	0.000	0.356	0.000

检查方法	敏感度	特异度	准确性
超声造影	77.4^a	84.0	80.4^be
弹性成像	54.8^c	72.0	62.5^d
联合	96.8	88.0	92.9
χ²值	15.123	2.283	15.485
P值	0.001	0.319	0.000

检查方法	敏感度	特异度	准确性
超声造影	77.4^a	84.0	80.4^be
弹性成像	54.8^c	72.0	62.5^d
联合	96.8	88.0	92.9
χ²值	15.123	2.283	15.485
P值	0.001	0.319	0.000

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