Value of SE and SWE elastic ultrasound in differential diagnosis of TI-RADS 4 thyroid nodule with a maximum diameter &le;1 cm

LI Gang; JIA Chao; LIU Long; ZHANG Fan; KUANG Yi; GAO Feng; SHI Qiusheng; DU Lianfang; LI Fan

doi:10.19732/j.cnki.2096-6210.2022.03.010

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Value of SE and SWE elastic ultrasound in differential diagnosis of TI-RADS 4 thyroid nodule with a maximum diameter ≤1 cm

更新时间：2025-12-15

- Value of SE and SWE elastic ultrasound in differential diagnosis of TI-RADS 4 thyroid nodule with a maximum diameter ≤1 cm
- Vol. 31, Issue 3, Pages: 275-280(2022)
- 作者机构：
- 作者简介：
- 基金信息：
- DOI：10.19732/j.cnki.2096-6210.2022.03.010
  CLC：
- Published Online：28 June 2022，
  
  Published：28 June 2022
- 稿件说明：
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李刚,贾超,刘龙,等. SE及SWE技术对1 cm的TI-RADS 4类甲状腺结节的鉴别诊断价值[J]. 肿瘤影像学, 2022, 31(3): 275-280 https://doi.

org/10.19732/j.cnki.2096-6210.2022.03.010
李刚,贾超,刘龙,等. SE及SWE技术对1 cm的TI-RADS 4类甲状腺结节的鉴别诊断价值[J]. 肿瘤影像学, 2022, 31(3): 275-280 https://doi. DOI： 10.19732/j.cnki.2096-6210.2022.03.010.

org/10.19732/j.cnki.2096-6210.2022.03.010 DOI：

摘要

目的：

探索应变弹性成像（strain elastography，SE）与剪切波弹性成像（shear-wave elastography，SWE）对最大径1 cm的甲状腺影像报告和数据系统（Thyroid Imaging Reporting and Data System，TI-RADS）4类甲状腺结节的鉴别诊断价值。

方法：

回顾并分析251例患者的263个甲状腺结节的超声检查结果，患者术前均行常规超声、SE及SWE检查，以手术后病理学检查或细针穿刺活检结果为金标准。在SE图像上，以结节周围同深度的甲状腺组织为参照，测量弹性应变率比值（strain ratio，SR）；在SWE图像上同理测量剪切波速度比（

ratio

）。通过受试者工作特征（receiver operating characteristic，ROC）曲线得到SR及

ratio

诊断截断值，评估不同检查方法的诊断效能。

结果：

研究共纳入恶性病灶144个，良性病灶119个。恶性组的SR和

ratio

值分别高于良性组（SR：3.14

1.20；

ratio

：2.13

1.21；

＜0.05）。SR、

ratio

及常规超声检查的ROC曲线的曲线下面积分别为0.896、0.840及0.746（

＜0.05）。以SR2.32对最大径1 cm的TI-RADS 4类恶性结节的灵敏度、特异度及诊断准确度分别为87.5%、88.2%及87.8%；联合常规超声及SR将诊断特异度提升至90.8%；常规超声与SR及

ratio

联合将诊断特异度提升至97.8%。

结论：

对于最大径1 cm TI-RADS 4类甲状腺结节，相较于

ratio

指标，SR指标对良恶性鉴别诊断具有较高效能，SR与常规超声联用，或进一步与SWE中

ratio

联用，可以提高诊断特异度，避免良性结节患者接受侵入性操作可能性。

Abstract

Objective:

To explore the value of strain elastography (SE) and shear wave elastography (SWE) in the differential diagnosis of Thyroid Imaging Reporting and Data System (TI-RADS) 4 thyroid nodules with a maximum diameter 1 cm.

Methods:

The ultrasonic imaging results of 263 thyroid nodules in 251 patients who underwent conventional ultrasound

SE and SWE before surgery were retrospectively analyzed

and the pathological results of surgical resection or fine-needle aspiration biopsy were the gold standard. On the SE image

the thyroid tissue around the nodule at the same depth was used as a reference to measure the strain ratio (SR); on the SWE image

the

ratio

was similarly measured. The diagnostic cutoff values of SR and

ratio

were obtained by receiver operating characteristic (ROC) curve to evaluate the diagnostic efficacy of different examination methods.

Results:

A total of 144 malignant lesions and 119 benign lesions were included in the study. The SR and

ratio

values of the malignant group were higher than those of the benign group (SR: 3.14

1.20;

ratio

: 2.13

1.21;

＜0.05). The areas under the ROC curves of SR

ratio

and ultrasound were 0.896

0.840 and 0.746

respectively (

＜0.05). The sensitivity

specificity and diagnostic accuracy of SR 2.32 in the diagnosis of TI-RADS 4 malignant nodules with a maximum diameter 1 cm were 87.5%

88.2% and 87.8%

respectively; combined with ultrasound and SR

the diagnostic specificity was increased to 90.8%; ultrasound combined with SRand

ratio

improved the diagnostic specificity to 97.8%.

Conclusion:

For TI-RADS 4 thyroid nodules with a maximum diameter 1 cm

compared with the

ratio

index

the SR index has higher efficacy in the differential diagnosis of benign and malignant. The combination o

f SR with conventional ultrasound

or further combined with

ratio

in SWE

can improve the diagnostic specificity and avoid the possibility of invasive procedures in patients with benign nodules.

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Value of SE and SWE elastic ultrasound in differential diagnosis of TI-RADS 4 thyroid nodule with a maximum diameter ≤1 cm

DOI：10.19732/j.cnki.2096-6210.2022.03.010

摘要

Abstract

关键词

Keywords

references