Value of ultrasound quantitative scoring and ultrasound elastography in the diagnosis and differential diagnosis of thyroid space occupying lesions

Abstract

Objective To explore the value of ultrasound quantitative scoring and ultrasound elastography in the diagnosis and differential diagnosis of thyroid space occupying lesions. Methods 193 patients with nodular thyroid lesions (245 thyroid nodules in total) diagnosed from January 2016 to December 2017 were selected as the study objects. The pathological results were used as the gold standard to draw the receiver operating characteristic (ROC) of the patients with malignant lesions predicted by conventional ultrasound quantitative score and ultrasound elastic imaging grading, and calculate the sensitivity, specificity, positive predictive value and negative predictive value predictive value, accuracy, area under curve (AUC) and 95% CI. Results Of 245 thyroid nodules, 174 were benign and 71 were malignant.The results of conventional ultrasound quantitative score showed that 70 of 193 patients had ultrasound quantitative score ≥4, and 74 of them had ultrasound elastic imaging grade of 4-5. The results of conventional ultrasound quantitative score showed that 70 of 193 patients had ultrasound quantitative score ≥ 4, and 74 of them had ultrasound elastic imaging grade of 4-5. 72 malignant nodules were detected by conventional ultrasound quantitative score, 52 were diagnosed correctly, 19 were missed and 20 were misdiagnosed. 75 malignant nodules were detected by ultrasound elastic imaging, 64 were diagnosed correctly, 7 were missed and 11 were misdiagnosed. The sensitivity and AUC of ultrasound elastic imaging were higher than that of ultrasound quantitative scoring (P<0.05), and the specificity of ultrasound quantitative scoring and elastic imaging positive were higher than that of ultrasound quantitative score combine with ultrasound elastic imaging, with statistically significant difference (P<0.05). The sensitivity of quantitative ultrasound scoring positive or elastography positive was higher than that of quantitative ultrasound scoring, elastography, quantitative and elastography, and the specificity was lower than that of quantitative and elastography, with statistically significant difference (P<0.05). Conclusions The clinical value of ultrasound elastography in the diagnosis of thyroid malignant nodule is better than that of conventional ultrasound quantitative scoring. The combination of the two methods is helpful to the diagnosis and exclusion of thyroid malignant nodule, which can be flexibly used according to the actual situation. Key words: Thyroid nodule; Thyroid neoplasms; Elasticity imaging techniques; Diagnosis, differential