Application of shear wave elastography combined with superb micro-vascular imaging in diagnosing benign and malignant thyroid masses

Abstract

Objective To investigate the application value of shear wave elastography (SWE) combined with superb micro-vascular imaging (SMI) in differentiating malignant and benign thyroid masses. Methods Seventy-eight patients diagnosed by ultrasound and verified with postoperative pathological analysis were enrolled. Conventional two-dimensional ultrasound was applied to observe the masses. SWE was performed to evaluate the elasticity and the Young′s modulus (AveT1) value acquired. ROC curve was drawn to calculate the sensibility and specificity using the cut-off value of AveT1. SMI was applied to define Adler′s grading standard according to the degree of blood supply. The sensitivity, specificity and accuracy of SWE and SWE combined with SMI in differentiating malignant and benign thyroid masses were analyzed. Results ①According to pathological analysis, there were 42 benign and 44 malignant masses; ②The AveT1 value between malignant and benign groups were all significantly different (P<0.01). 41.4 kPa was used as the best cut-off value of AveT1. The area under the ROC curve were 0.83 with sensitivity 86.9% and specificity 88.1%; ③There were more masses with the Alder class Ⅱ-Ⅲ in malignant group than those in benign group, and the difference was statistically significant (P<0.01); ④Quantified with SWE or SWE combined with SMI, the sensitivity were 86.9% and 91.3%, specificity were 88.1% and 92.8%, and accuracy were 87.5% and 94.1%, respectively, and the difference was statistically significant (P<0.01). Conclusions SWE combined with SMI represents an excellent application value in differentiating malignant and benign thyroid masses, which could improve the sensitivity, specificity and accuracy of the diagnosis for thyroid masses using ultrasound. Key words: Real-time shear wave elastography; Superb micro-vascular imaging; Thyroid neoplasms