›› 2020, Vol. 40 ›› Issue (1): 76-.doi: 10.3969/j.issn.1674-8115.2020.01.012

• Original article (Clinical research) • Previous Articles     Next Articles

Diagnostic efficiency of ultrasound TI-RADS combined with three-dimensional shear wave elastography in thyroid microcarcinoma

HAN Rui-jun, DU Jing, CHEN Cui, ZHU Cai-xia, LI Feng-hua, WANG Jia-dong   

  1. 1. Department of Ultrasound, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; 2. Department of Head and Neck Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2020-01-28 Published:2020-03-05
  • Supported by:
    Scientific Research Plan Project of Shanghai Science and Technology Commission (16411968800); Health and Family Planning Joint Research Project of Pudong New Area Health Commission (PW2019D-6).

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Abstract: Objective · To evaluate the diagnostic value of ultrasound thyroid imaging-reporting and data system (TI-RADS) combined with three-dimensional shear wave elastography (3D-SWE) technique in thyroid microcarcinoma. Methods · Jun. 2017 to Jan. 2018, 66 patients with 67 thyroid nodules in the Department of Ultrasound of Renji Hospital, Shanghai Jiao Tong University School of Medicine were recruited. All thyroid nodules were classified as TI-RADS 4-5, and the maximum diameter was 5.0-10.0 mm. After routine ultrasound examination, all thyroid nodules were evaluatedTI-RADS classification, 3D-SWE technique, fine-needle aspiration biopsy (FNAB) examination and an additional BRAFV600E gene mutation test. All the nodules were divided into benign group and malignant group according to the results of surgical pathology or fine-needle aspiration combined with BRAFV600E gene detection. The threshold value of the parameters in 3D-SWE for differentiating benign and malignant thyroid nodules was calculated, and the TI-RADS was further adjustedYoungs modulus parameters of the lesion to obtain combined TI-RADS (conventional ultrasound combined with 3D-SWE) for detecting the benign and malignant nodules. Results · Among the 67 thyroid nodules, 38 of them were malignant and 29 were benign. The optimal cut-off point of three-dimensional maximum Youngs modulus in sagittal plane (3D-S-Emax) was 24.6 kPa. The area under the curve (AUC) value, sensitivity, specificity and accuracy of 3D-S-Emax were 0.683, 65.8%, 65.5% and 65.7%, respectively. The AUC value for combined TI-RADS was 0.801 and that for conventional TI-RADS was 0.794, without statistical difference. The sensitivity, specificity and accuracy of conventional TI-RADS and combined TI-RADS were 63.2%, 82.8%, 71.6%, and 86.8%, 69.0%, 79.1%, respectively. Only sensitivity of combined TI-RADS was significantly higher than that of conventional TI-RADS (P0.004). Conclusion · Combined TI-RADS and conventional TI-RADS have similar diagnostic value in thyroid microcarcinoma, while combined TI-RADS has higher diagnostic sensitivity and lower missed diagnosis rate.

Key words: thyroid nodule, ultrasound, three-dimensional shear wave elastography (3D-SWE), thyroid imaging-reporting and data system (TI-RADS)