Ultrasound Elastography Using Carotid Artery Pulsation in the Differential Diagnosis of Sonographically Indeterminate Thyroid Nodules
- Authors
- Choi, Woo Jung; Park, Jeong Seon; Koo, Hye Ryoung; Kim, Soo-Yeon; Chung, Min Sung; Tae, Kyung
- Issue Date
- Feb-2015
- Publisher
- AMER ROENTGEN RAY SOC
- Keywords
- carotid artery pulsation; elastography; thyroid nodule; thyroid ultrasound
- Citation
- AMERICAN JOURNAL OF ROENTGENOLOGY, v.204, no.2, pp.396 - 401
- Indexed
- SCIE
SCOPUS
- Journal Title
- AMERICAN JOURNAL OF ROENTGENOLOGY
- Volume
- 204
- Number
- 2
- Start Page
- 396
- End Page
- 401
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/157971
- DOI
- 10.2214/AJR.14.12871
- ISSN
- 0361-803X
- Abstract
- OBJECTIVE. The purpose of this study was to evaluate the diagnostic performance of gray-scale ultrasound and a new method of thyroid ultrasound elastography using carotid artery pulsation in the differential diagnosis of sonographically indeterminate thyroid nodules. MATERIALS AND METHODS. A total of 102 thyroid nodules with indeterminate gray-scale ultrasound features from 102 patients (20 males and 82 females; age range, 16-74 years; mean age, 51 years) were included. The gray-scale ultrasound images of each nodule were reviewed and assigned a score from 1 (low) to 5 (high) according to the possibility of malignancy. Ultrasound elastography was performed using carotid pulsation as the compression source. The elasticity contrast index (ECI), which quantifies local strain contrast within a nodule, was automatically calculated. The radiologist reassessed the scores after concurrently reviewing gray-scale ultrasound and elastography. ROC curve analysis was used to evaluate the diagnostic performances of each dataset and to compare the AUC (A(z)) values of gray-scale ultrasound score alone, ECI alone, and a combined assessment. RESULTS. Significantly more malignant thyroid nodules were hypoechoic than benign nodules (p = 0.014). The ECI was significantly higher in malignant nodules than in benign thyroid nodules. The A(z) values of each dataset were 0.755 (95% CI, 0.660-0.835) for gray-scale ultrasound score, 0.835 (0.748-0.901) for ECI, and 0.853 (0.769-0.915) for a combined assessment. The A(z) value for a combined assessment of the gray-scale ultrasound score and the ECI was significantly higher than that for the gray-scale ultrasound score alone (p = 0.022). CONCLUSION. Combined assessment with gray-scale ultrasound and elastography using carotid artery pulsation is helpful for characterizing sonographically indeterminate thyroid nodules as benign or malignant.
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