Clinical Value Of Conventional Ultrasound Combined With Ultrasonic Elastography In Differential Diagnasis Of Thyroid Nodules

Objective: To investigate the value of ultrasonic elastography(UE), conventional Ultrasound and combined method in the qualitative diagnosis of thyroid nodules and provide more information for the therapy and prognosis of thyroid cancers. Methods:CUS and UE were used to examine a total of 101 patients with 125 thyroid nodules with surgical pathological results as golden standard. Routine sonography features such as shape、borderline、internal echo、micro calcification、color flow mapping of thyroid nodules were carefully detected on conventional ultrasonography and UE score was also recorded.The sentivity(Sen), specificity(Spe), crude accuracy(CA) and the area under the ROC curve was calculated respectively. Comparative analysis was performed between CUS, UE and combination of two methods. Results: 1.Conventional ultrasound image characteristics such as form, boundary, aspect ratio, internal echo and presence of microcalcification, internal blood supply, silent sparkle, rear echo attenuation and the differences of lymph node metastasis had a significant meaning(P < 0.05) in differential diagnosis of benign and malignant thyroid nodules; TI- RADS grading and elasticity score difference of Benign and malignant thyroid nodules have statistical significance(P <0.01).2.The sensitivity, specificity and accuracy of conventional ultrasonic diagnosis of thyroid nodules was respectively 72.73%, 79.35% and 77.60%; The sensitivity,specificity and accuracy of elasticity imaging in diagnosis of thyroid nodules was 84.85%, 90.22%and 88.80%. The sensitivity, specificity and accuracy of combination of CUS and UE was respectively90.91%, 93.48% and 92.80%. 3. The area under the ROC curve of eIastiosonography(0.895)was larger than that of conventional ultrasonography(0.819).The area under the ROC curve of combination(0.922)was larger than that of CUS and UE.Conclusion: 1.Conventional ultrasound imaging can show some specific characters in differentiatial diagnosis of malignant thyroid nodules from benign 2. Ultrasound elastography is a new developing imaging technique. It can provide extra and valuable information for clinicians to diagnose thyroid cancers. 3. Our study indicated that combination of CUS and UE could overcome current imaging limitations and increase diagnosis accuracy of throid cancers.4. Ultrasound elasticity imaging and conventional ultrasound can complement each other and have certain application value in the differential diagnosis of thyroid nodules.