Real-time ultrasound elastography in the differential diagnosis of benign and malignant thyroid nodules.
OBJECTIVE
The purpose of this study was to evaluate the diagnostic utility of real-time ultrasound elastography in differentiating benign from malignant thyroid nodules.


METHODS
A total of 90 consecutive patients with thyroid nodules who were referred for surgical treatment were examined in this prospective study. One hundred forty-five nodules in these patients were examined by B-mode ultrasound, color Doppler ultrasound, and ultrasound elastography. The final diagnosis was obtained from histologic findings. Tissue stiffness on ultrasound elastography was scored from 1 (low stiffness over the entire nodule) to 6 (high stiffness over the entire nodule and surrounding tissue).


RESULTS
On real-time ultrasound elastography, 86 of 96 benign nodules (90%) had a score of 1 to 3, whereas 43 of 49 malignant nodules (88%) had a score of 4 to 6 (P <.001), with sensitivity of 88%, specificity of 90%, a positive predictive value of 81%, and a negative predictive value of 93%. The predictivity of ultrasound elastographic measurement was independent of the nodule size. High sensitivity (88%) and specificity (93%) were also observed in 68 nodules that had a greatest diameter of 1 cm or less.


CONCLUSIONS
Real-time ultrasound elastography is a promising imaging technique that is useful in the differential diagnosis of thyroid cancer.
Hong
Yurong
Y
Second Affiliated Hospital, Zhejiang University College of Medicine, Zhejiang, China.
Liu
Xueming
X
Li
Zhiyu
Z
Zhang
Xiufang
X
Chen
Meifeng
M
Luo
Zhiyan
Z
D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003199:Computer Systems; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000473:pathology; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D055815:Young Adult