The Value Of Ultrasound Elastography Combined Micropure In Differentiating Benign And Malignant Thyroid Nodules

ObjectiveThe study aim to explore the application of combining MicroPure andElastography in differentiating benign and malignant thyroid nodules，And withother united comparison method， The former is determined in that position andsignificance of malignant thyroid nodules.Materials and MethodsTwo hundred and ten patients with one or more thyroid nodules in theQianfoshan Hospital of Shandong Province from January2012to December2012were examined, including148female and62male,whose mean age is49.69±10.82years(age range17-76years). There are totally284nodules(whichincluded183benign,101malignant) of these patients. Informed consent fordiagnostic procedures was obtained from all patients. All the nodules wereexamined by both conventional ultrasonic sonography、 Ultrasonic micropuresystem and elastography at first, while having the cytological or histologicalpathology results. The collection and analysis of conventional ultrasoundimaging and Ultrasonic micropure system elastography imaging wereundertaken by three similar working experience in ultrasound doctors withdouble-blind method. The standard that select nodules is as follows：(1)theywere all euthyroid and without other thyroid disease.(2)Shell-calcifed nodules、cystic nodules、 mixed nodules with cyst component greater than30%of thenodule total volume were excluded from the study.(3)patients who are withouthistopathology were also excluded. Retrospective analysis:(1) The SPSS forWindows version17.0software package was used for statistical data analysis. To find the best cut off point of strain ratio by Youden﹐s index using receiveroperating characteristic ROC curve. The sensitivity, specifcity, positivepredictive value, negative predictive value for each index of three methods wascalculated。（3）Combined several meaningful index and calculate the sensitivity,specifcity, PPV、 NPV and to compare the sensitivity、 specifcity of each index.P<0.05indicated statistical significance.(4) To evaluat Ultrasound elastographycombined MicroPure in distinguishing malignant nodules from thyroid lesions.ResultWhen the most accurate cut-off point of stain ratio was3.75， highsensitivity and specificity, were84.2%,84.2%. Constructing the ROC curves,the area under the curve were0.854. The mean SR value of malignant nodules:x=4.30±1.44, The mean SR value of benign nodules: x=2.79±0.92. Two sets ofdata using the independent samples t test with P <0.05with a statisticalsignificance. The sensitivity,specificity of MicroPure imaging in the diagnosisof thyroid lesions were56.4%,98.3%respectively. The sensitivity, specificityof obscure boundary,irregular morphous,nought acoustic halo were52.5%、89.6%，47.5%、90.7%，64.4%、86.9%respectively.Strain ratio combinedMicroPure in all index received the highest sensitivity, specificityrespectively (93.1%,95.6%). Elastography and MicroPure respectivelycombined other index could received higher sensitivity and specificity.ConclusionThe combination of ultrasound elastography（strain ratio）and MicroPure isof significance and value for differentiation of benign and malignant thyroidnodules.