| Part 1 To explore the value of ultrasonic elastic strain rate and virtual touch tissue quantification in identity of benign and malignant thyroid noduleObjective:To explore the value of ultrasonic elastic strain rate(SR)and virtual touch tissue quantification(VTQ)two methods diagnosis of benign and malignant thyroid nodule.Methods:128 patients with thyroid nodule which need surgical treatment were selected as research objective.Before surgical treatment,All thyroid nodules detection with two-dimensional and color doppler ultrasoundand and classification by TI-RADS;All thyroid nodules measuring the SR of thyroid nodule as referenced of sternocleidomastoid;All thyroid nodules conducted with VTQ detection and recorded by shear wave velocity(SWV).Receiver operator characteristic curve(ROC)was used to evaluate TI-RADS,SR and VTQ in identifying benign and malignant thyroid nodule which by surgery pathology as the gold standard.Results:TI-RADS,SR and VTQ had statistically significant(P<0.05)in benign and malignant thyroid nodules,the area under the ROC curve of TI-RADS,SR and VTQ were respectively 0.83,0.87,0.92.Conclusion:VTQ could improve the accuracy of ultrasonography in identifying benign and malignant thyroid nodule.Part 2 Evaluation of the stiffness of tissues surrounding thyroid nodules with shear wave elastographyObjective:This study evaluated the stiffness of tissue surrounding thyroid nodules using shear wave elastography(SWE).Methods:A total of 128 thyroid nodules in 108 people(mean age 33.12 ± 13.34 years,range 18–80 years)were examined with conventional ultrasound(US)and SWE in Anhui Provincial Hospital,Anhui Medical University.All thyroid nodules were classified by conventional US features according to the Thyroid Image Reporting and Data System(TI-RADS).The Young’s modulus maximum value was measured to evaluate the stiffness of the thyroid nodules(recorded as E)and in the 2-mm peri-nodule region(recorded as Eshell).The number of thyroid fibroblasts was evaluated using Masson’s trichrome staining and Image J software.The arrangement of the fibrous structure was also classified.Results:Thirty-nine thyroid nodules were classified as benign and 72 as malignant.Eshell was significantly higher for malignant nodules(95.0 ± 21.9)k Pa compared with benign nodules(48.1 ± 17.0)k Pa(P <.001).Eshell yielded an area under the receiver operator characteristic curve value of 0.951,used in the diagnosis of nodules.There was a high positive correlation between the E and the Eshell in the malignant group(R=0.722,P < 0.001),and a moderate positive correlation in the benign group(R=0.601,P < 0.001).Percentages of fibroblasts correlated highly with Eshell in all samples,as well as in malignant samples(R=0.759,R=0.865,P < 0.001,respectively).The degree of disorder of the tissue surrounding thyroid nodules was positively correlated with Eshell(R=0.833).Conclusions:The Eshell values was positive correlation with the E values and the the Eshell values has potential to improve diagnosis of thyroid nodules.Part3 The use of shear wave elastography for measuring the stiffness of tissue of different widths surrounding the thyroid nodule as a diagnostic tool for thyroid cancer malignancyObjective: To explore the value of shear wave elastography(SWE)for measuring the stiffness of tissue of different widths surrounding the thyroid nodule to diagnose malignancy.Methods: A total of 129 solid thyroid nodules in109 people(mean patient age,33.12 ± 13.34 years;range,18–80;79%(77/98)were female)were examined with conventional ultrasound and SWE.The Young’s modulus max valuate assessment method was utilized to quantitatively evaluate the stiffness of the thyroid nodules and different widths of the surrounding tissues.An ROI was placed in the center of each thyroid nodule and the maximum Young’s modulus(E)was recorded.The ROI was then positioned in the 0.5mm,1mm and 2 mm peri-nodule region,and the Young’s modulus max value of this ROI was recorded using the Shell function(Eshell0.5,Eshell1,Eshell2).Results: A total of 39 thyroid nodules were malignant and 90 were benign.The stiffness of the tissues of different widths surrounding the malignant thyroid nodules was higher than that of benign thyroid nodules(Eshell0.5(80.1±11.0)VS(64.5±11.8))k Pa,Eshell1(80.6±11.0)VS(61.9±11.8)k Pa,Eshell2(92.1±18.5)VS(48.6±14.4)k Pa,P < 0.001).The stiffness of tissues of different widths surrounding the thyroid nodules was highly correlated with their internal stiffness.Eshell0.5 of the benign group,malignant group,and overall specimens were highly correlated with the E(R= 0.92,R = 0.88,R = 0.93).Eshell2 yielded an area under the receiving operating curve value of 0.95 for the diagnosis of thyroid nodules.Conclusion: Eshell0.5 of the benign group,malignant group,and overall specimens were highly correlated with the E.Eshell2 improved diagnostic accuracy in thyroid nodules. |
