title: Application of Real-time Ultrasound Elastography in Diagnosing Benign and Malignant Thyroid Solid Nodules.
abstract: OBJECTIVE
  Real-time ultrasound elastography (US-E) is a helpful tool in diagnosing thyroid nodules. This study aims to evaluate thyroid solid nodules, to establish the accuracy of US-E in providing information on the nature of these nodules, and to assess the clinical value of elasticity scores (ES) and strain ratio (SR) in differentiating thyroid solid nodules and to explore its distribution characteristics using pathological analysis as reference.
  
  
  METHODS
  Traditional ultrasonography and US-E were performed on 131 thyroid solid nodules (99 benign ones and 32 malignant ones) in 120 patients (78 females and 41 males). Three radiologists evaluated the nodules based on a four-degree elasticity scoring system. The nodules were classiﬁed according to the ES as soft (ES 1-2) or hard (ES 3-4). The SR was calculated online.
  
  
  RESULTS
  The sensitivity and speciﬁcity of the ES for thyroid cancer diagnosis were 78% and 80%, respectively. SR values ≥ 2.9 used as a standard to distinguish benign from malignant nodules had a sensitivity of 87% and a specificity of 92%. The SR of the benign lesions was 1.64±1.37, which was significantly different from that of malignant lesions, which was 4.96±2.13 (P<0.01).
  
  
  CONCLUSIONS
  Both the ES and SR were higher in malignant nodules than those in benign ones. Real-time US-E was a useful index in the differential diagnosis of thyroid solid nodules. It can provide quantitative information on thyroid nodule characterization and improve diagnostic confidence.
authors.affiliation: Department of Ultrasonographic Diagnosis and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China.
authors.forename: Hai-Ling
authors.initials: HL
authors.lastname: Wang
authors.forename: Sheng
authors.initials: S
authors.lastname: Zhang
authors.forename: Xiao-Jie
authors.initials: XJ
authors.lastname: Xin
authors.forename: Li-Hui
authors.initials: LH
authors.lastname: Zhao
authors.forename: Chun-Xiang
authors.initials: CX
authors.lastname: Li
authors.forename: Jia-Li
authors.initials: JL
authors.lastname: Mu
authors.forename: Xue-Qing
authors.initials: XQ
authors.lastname: Wei
keywords: elasticity scores; strain ratio; thyroid solid nodule; ultrasound elastography