| Objective:To compare the value of conventional ultrasound, ultrasound imaging area ratio method(EIAR) and the combination of two methods in the differential diagnosis of benign and malignant thyroid nodules.Methods:From November 2014 to December 2015, 116 patients including 35 males and81 females who were suffered with thyroid nodules received surgery removal in our hospital. The age of the patients was 18-66 years old, the average age was37.99±10.31. All the nodules were add up to 125 and confirmed by pathological results, the dimeter of which was no more than 3cm. Thyroid ultrasound examination were performed before operation. First, high-frequency Germany Siemens ACUSON S2000 ultrasound was used to check the size, location, shape, border, internal echo and calcification of thyroid tumors and cervical lymph nodes. Then ultrasound diagnostic instrument was performed for elasticity imaging. The average diameter of the nodules was calculated. Then start ultrasound elastography mode and adjust the size of interested region about two times larger than the thyroid nodules. At the same time, make sure the displayed quality index(QF) was bigger than 60 so that the image quality was stable and repeatable. We used EIAR to evaluate the thyroid nodules. First, trace the nodule area on the elasticity image, second, trace the nodule area on two-dimensional image, and then the EIAR will appear automatically. The best cut-off point of EIAR was obtained using receiver operating characteristic curve analysis. All data was stored in the instrument, and the postoperative pathologicalresults were compared with the ultrasound results after operation. The tests were repeated 3 times, and then took the average results. The data of all thyroid nodules was statistically analyzed through SPSS20.0 software using data matching tables.T-test was adopted in measurement data. The results with P< 0.05 showed statistical significance.Results:1. Histopathological results of all the 125 thyroid nodules showed that 78 of them were benign tumors and the other 47 were malignant ones.2. Conventional ultrasound in differentiating benign and malignant thyroid nodules : the differences in the shape, boundary, internal echo, aspect ratio,calcification and other aspects are statistically significant, p<0.01.3. The sensitivity 、 specificity 、 accuracy of conventional ultrasound in the diagnosis of benign and malignant thyroid nodules was respectively 76.6%(36/47),70.5%(55/78), and 72.8%(91/125).4. The EIAR of benign thyroid nodules was 1.234±0.119, and that of malignant thyroid nodules was 1.531±0.156, which was significantly higher than that of benign nodules(p<0.01). Draw the ROC curve with sensitivity as vertical coordinate and 1-specificity as the horizontal coordinate. It showed that the AUC was 0.868 and the best cut-off point of EIAR was 1.36. The sensitivity、specificity、accuracy of EIAR in the diagnosis of benign and malignant thyroid nodules was respectively83.0%(39/47), 78.2%(61/78) and 80.0%(100/125).5. The sensitivity、specificity、accuracy of conventional ultrasound combined EIAR in the diagnosis of thyroid nodules was respectively 93.6%(44/47)、74.4%(58/78)、81.6%(102/125).Conclusions:1. Conventional ultrasound is the most common tool for thyroid examination,and its two-dimensional features can not be replaced in the diagnosis of thyroid nodules.2. The EIAR assess thyroid nodules in a semiquantitive way, which has higher diagnosic value.3. The value of conventional ultrasound combined with EIAR in the diagnosis of thyroid nodules is superior to conventional ultrasound 、EIAR.4. Although there’s a large variation of the EIAR limit point in different study, its role in the differential diagnosis of benign and malignant thyroid nodules is significant. |
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