The Role And Significance Of Ultrasonic Quantitative Scoring Method And Real-time Elastosonography Method In Diagnosis Of Thyroid Nodules

Part I The role and significance of ultrasonic quantitative scoring method in the diagnosis of thyroid nodulesObjective: Through the ultrasonic quantitative scoring method, to explore the diagnosis for thyroid nodules. Compared with the pathologic diagnosis, to study the role of ultrasonic in clinical.Method: A total of 245 nodules were collected with a complete data. The size, aspect radio shape, margin, inter-echo, halo sign, calcification and acoustic attenuation were analyzed by the ultrasonic quantitative scoring method. And the distributions of color flow signals in or surround of thyroid nodules were observed and scored by ultrasonic method. Using ROC curve to analyze the positive predictive value and negative predictive values in diagnosis by ultrasonic quantitative score method.Results:(1) 245 thyroid nodules were collected, including 180 cases of benign nodules and 65 cases of malignant nodules. The scores of thyroid benign nodule was lower than that of thyroid malignant nodule, and the difference was statistically significant(P<0.01).(2) Analyzed by ROC curve(receiver operating characteristic curve, ROC curve), the threshold score for distinguishing benign and malignant thyroid nodules was 11.5.(3) Compared with pathologic diagnosis, the sensitivity, specificity, accuracy rate, positive predictive value and negative predictive value of ultrasonic quantitative scoring method were 78.5%, 81.8%, 80.4%, 60.0% and 91.3%, respectively.Conclusion: Ultrasonic quantitative scoring method could increase accuracy rate in diagnosis of thyroid nodules, and play an important role in clinical.PartⅡ The role and significance of real-time elastosonography in diagnosis of thyroid nodulesObjective: To explore and analyze the value of real-time elastosonography in diagnosis of thyroid nodules. To investigate the relationship between elastosonography and collagen fibre as well as their contribution in the diagnosis of thyroid nodules.Methods: 112 nodules were collected and examined by conventional ultrasound and real-time elastosonography. The sensitivity, specificity, accuracy rate, positive predictive value and negative predictive value were calculated by real-time elastosonography and conventional ultrasound. The diagnostic value of real-time elastosonography was analyzed by ROC. The collagen fibre density was determined by Masson staining. And the relationship between collagen fibre and real-time elastosonography were analyzed.Results:(1) 112 thyroid nodules were collected, including 92 cases of benign nodules and 20 cases of malignant nodules. The results of ROC curve showed the elasticity grade in benign nodules ranged from grade 0 to grade 2, and the majority of the elasticity grade in malignant nodules ranged from grade3 to grade 4(P<0.01).(2) Compared with conventional ultrasound, the sensitivity, specificity, accuracy rate, positive predictive value and negative predictive value of ultrasonic quantitative scoring method were 89.5%, 90.7%, 90.5%, 66.7% and 97.7%, respectively.(3) The results of Masson staining showed that collagen fibre of thyroid carcinoma was higher than that in benign nodules. And close relationship was found between collagen fibre and real-time elastosonography score(P<0.01, r=0.472).Conclusion: Real-time elastosonography can improve accuracy rate in diagnosis of thyroid nodules, and play an important role in surgery or fine needle aspiration under real-time elastosonography.