title: [Value of ROI A value in strain ratio and elasticity scores in differential diagnosis of thyroid nodules using ultrasonic elastography].
abstract: OBJECTIVE
  To study the value of ROI A value in the strain ratio and the elasticity scores by the 4-score system in ultrasonic elastography in differential diagnosis of benign and malignant thyroid nodules.
  
  
  METHODS
  A total of 124 patients with 166 thyroid nodules underwent examinations with real-time ultrasonic elastography to obtain the elasticity score and the ROI A value in strain ratio. Receiver operating characteristic (ROC) curves were used to assess the diagnostic value of ROI A value, and the best cutoff point was determined. The results of diagnosis based on ROI A value, elasticity scores, and their combination were compared with the results of pathological diagnosis.
  
  
  RESULTS
  The area under the ROC curve (Az) of ROI A value for differentiating benign and malignant thyroid nodules was 0.825. The best diagnostic cut-off point of ROI A value was 0.00165. In differentiating benign and malignant thyroid nodules, the sensitivity, specificity, accuracy and odds ratio were 82.93%, 72.80%, 75.30%, and 13.0 for ROI A value, 87.80%, 80.00%, 81.93%, and 28.8 for the elasticity scores, and 73.17%, 91.20%, 86.75%, and 32.1 for their combination, respectively. The odds ratio of the combined diagnosis was the highest, and the accuracy of the combined diagnosis was significantly higher than that of ROI A value (χ(2)=19.31, P<0.05) and the elasticity scores (χ(2)=12.03, P<0.05).
  
  
  CONCLUSIONS
  ROI A value has moderate diagnostic value and clinical practicability in differentiating thyroid nodules. The diagnostic accuracy of ROI A value can be improved by combining with the elasticity scores.
authors.affiliation: Guangdong Academy of Medical Sciences/ Department of Ultrasound, Guangdong General Hospital, Guangzhou 510080, China. xiuyanwlc@yahoo.com.cn
authors.forename: Xiuyan
authors.initials: X
authors.lastname: An
authors.forename: Shuzhen
authors.initials: S
authors.lastname: Cong
authors.forename: Jun
authors.initials: J
authors.lastname: Qian
authors.forename: Yuping
authors.initials: Y
authors.lastname: Guo
authors.forename: Lifeng
authors.initials: L
authors.lastname: Zhou
authors.forename: Ting
authors.initials: T
authors.lastname: Liang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D016606:Thyroid Nodule / Q000000981:diagnostic imaging*; D055815:Young Adult