양성과 악성 갑상선 결절의 감별 진단에서 탄성 초음파
Ultrasound Elastography in Differential Diagnosis of Benign and Malignant Thyroid Nodules
0
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Purpose: The study evaluated elastography, a technique that allows differentiation between pathological and normal tissue by determination of tissue hardness. Methods: From March 2009 to April 2010, 25 consecutive patients with thyroid nodules who were referred for surgical treatment were examined in this prospective study. Thirty nodules in these patients were examined by conventional ultrasound, ultrasound elastography, and fine needle aspiration cytology. Lesions were scored (1∼3) according to hardness based on the Ueno classification system. The final diagnosis was based on histopathologic results. Results: Of the 30 thyroid nodules, four were classified as benign and 26 were malignant. Two of the nodules with an elastography score of 1 were benign and 17 nodules whose elastography score was 3 were malignant. Two benign nodules and nine malignant nodules had an elastography score of 2. Applying an elastography score exceeding 2 as a indicator for malignancy determined that the sensitivity and specificity of the ultrasound elastography was 100.0% and 50.0%, respectively, the positive and negativepredictive values were 92.9% and 100.0%, respectively, and the accuracy of the technique was 93.3%. Conclusion: Ultrasound elastography may be a useful adjunct to ultrasonography in the identification of indeterminate thyroid nodules for which tissue diagnosis is required. (Korean J Endocrine Surg 2010;10:229-234)
Abstract
Purpose: The study evaluated elastography, a technique that allows differentiation between pathological and normal tissue by determination of tissue hardness. Methods: From March 2009 to April 2010, 25 consecutive patients with thyroid nodules who were referred for surgical treatment were examined in this prospective study. Thirty nodules in these patients were examined by conventional ultrasound, ultrasound elastography, and fine needle aspiration cytology. Lesions were scored (1∼3) according to hardness based on the Ueno classification system. The final diagnosis was based on histopathologic results. Results: Of the 30 thyroid nodules, four were classified as benign and 26 were malignant. Two of the nodules with an elastography score of 1 were benign and 17 nodules whose elastography score was 3 were malignant. Two benign nodules and nine malignant nodules had an elastography score of 2. Applying an elastography score exceeding 2 as a indicator for malignancy determined that the sensitivity and specificity of the ultrasound elastography was 100.0% and 50.0%, respectively, the positive and negativepredictive values were 92.9% and 100.0%, respectively, and the accuracy of the technique was 93.3%. Conclusion: Ultrasound elastography may be a useful adjunct to ultrasonography in the identification of indeterminate thyroid nodules for which tissue diagnosis is required. (Korean J Endocrine Surg 2010;10:229-234)
참고문헌 (25)
- Tan GH, "Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging", Ann Intern Med, 126, pp.226~231 (1997)
- Ross DS, "Nonpalpable thyroid nodules--managing an epidemic", J Clin Endocrinol Metab, 87, pp.1938~1940 (2002)
- Siperstein AE, "Thyroid diseases: tumors, carcinoma of follicular epithelium, surgical therapy. In: Braverman LE, Utiger RD, eds. Werner and Ingbar's the Thyroid: A FundaMental And Clinical Text. 8th ed", pp.898~899 (2000), Lippincott Williams & Wilkins
- Tan GH, "Solitary thyroid nodule. Comparison between palpation and ultrasonography", Arch Intern Med, 155, pp.2418~2423 (1995)
- Baloch ZW, "Fine- needle aspiration of thyroid: an institutional experience", Thyroid, 8, pp.565~569 (1998)
- Agrawal S, "Diagnostic accuracy and role of fine needle aspiration cytology in management of thyroid nodules", J Surg Oncol, 58, pp.168~172 (1995)
- Takashima S, "Thyroid nodules: re-evaluation with ultrasound", J Clin Ultrasound, 23, pp.179~184 (1995)
- Lerner RM, ""Sonoelasticity" images derived from ultrasound signals in mechanically vibrated tissues", Ultrasound Med Biol, 16, pp.231~239 (1990)
- Ophir J, "Elastography: ultrasonic estimation and imaging of the elastic properties of tissues", Proc Inst Mech Eng H, 213, pp.203~233 (1999)
- Ophir J, "Elastography: a quantitative method for imaging the elasticity of biological tissues", Ultrason Imaging, 13, pp.111~134 (1991)
- Ophir J, "Elastographic imaging", Ultrasound Med Biol, 26, pp.23~29 (2000)
- Itoh A, "Breast disease: clinical application of US elastography for diagnosis", Radiology, 239, pp.341~350 (2006)
- Tardivon A, "Elastography of the breast: a prospective study of 122 lesions", J Radiol, 88, pp.657~662 (2007)
- Taylor LS, "Prostate cancer: three-dimensional sonoelastography for in vitro detection", Radiology, 237, pp.981~985 (2005)
- Thomas A, "Real-time sonoelastography of the cervix: tissue elasticity of the normal and abnormal cervix", Acad Radiol, 14, pp.193~200 (2007)
- Lyshchik A, "Thyroid gland tumor diagnosis at US elastography", Radiology, 237, pp.202~211 (2005)
- Rago T, "Potential value of elastosonography in the diagnosis of malignancy in thyroid nodules", Q J Nucl Med Mol Imaging, 53, pp.455~464 (2009)
- Rago T, "Elastography: new developments in ultrasound for predicting malignancy in thyroid nodules", J Clin Endocrinol Metab, 92, pp.2917~2922 (2007)
- Ueno E, "Diagnosis of breast cancer by elasticity imaging", Eizo Joho Medical, 36, pp.2~6 (2004)
- Brander A, "Thyroid gland: US screening in a random adult population", Radiology, 181, pp.683~687 (1991)
- Ahn SY, "The diagnostic values of ultrasonography in the papillary thyroid carcinoma", J Clinical Otolaryngol, 20, pp.55~59 (2009)
- Hegedüs L, "Clinical practice. The thyroid nodule", N Engl J Med, 351, pp.1764~1771 (2004)
- Tranquart F, "Elastosonography of thyroid lesions", J Radiol, 89, pp.35~39 (2008)
- Asteria C, "US-elastography in the differential diagnosis of benign and malignant thyroid nodules", Thyroid, 18, pp.523~531 (2008)
- Rubaltelli L, "Differential diagnosis of benign and malignant thyroid nodules at elastosonography", Ultraschall Med, 30, pp.175~179 (2009)