使用二维剪切波弹性成像技术区分甲状腺结节和甲状旁腺病变：提高诊断准确性的新方法。
Differentiating thyroid nodules parathyroid lesions using 2D-shear-wave elastography: a novel approach for enhanced diagnostic accuracy.
发表日期：2023
作者：
Dana Stoian, Andreea Borlea, Laura Taban, Felix-Mihai Maralescu, Flaviu Bob, Oana Schiller, Adalbert Schiller, Octavian Neagoe
来源：
Frontiers in Endocrinology
摘要：
在某些情况下，通过超声波区分甲状腺和甲状旁腺病变可能是一项挑战。本研究探讨了双二维剪切波弹性成像平面超声（2D SWE PLUS）作为辅助技术在区分这些表浅结构中的诊断效能。我们通过常规超声和2D SWE PLUS评估了86例同时存在甲状腺结节和甲亢的病例，采用Aixplorer Supersonic Mach30超声仪和5-18 MHz线性探头。在甲状旁腺和正常甲状腺组织之间的弹性指数（EI）之间观察到了统计学上显著差异（p<0.0001, U=291），以及甲状旁腺病变和甲状腺结节之间的显著差异（p<0.0001, U=248.5）。建立了AUC为0.961，最佳截断值为≤8.9 kPa，有效区分甲状旁腺组织和正常甲状腺组织（敏感性91.9%，特异性97.5%）。此外，发现AUC为0.963，最佳截断值为9.24 kPa（敏感性94.2%，特异性91.1%）用于区分甲状旁腺和甲状腺病变。与良性甲状腺结节相比，癌症组的弹性值显著升高（p<0.0001）。我们的研究结果表明，2D SWE PLUS是区分甲状腺结节和甲状旁腺病变的有效工具，提高了颈部超声检查的诊断效能。版权所有©2023 Stoian, Borlea, Taban, Maralescu, Bob, Schiller, Schiller and Neagoe.
Differentiating between thyroid and parathyroid lesions by means of ultrasound can be a challenge in some cases. This study explores the diagnostic efficacy of bidimensional shear wave elastography planewave ultrasound (2D SWE PLUS) as an auxiliary technique in distinguishing these superficial structures. We evaluated 86 cases, presenting with concurrent thyroid nodules and hyperparathyroidism, through conventional ultrasound and 2D SWE PLUS, employing an Aixplorer Supersonic Mach30 with a 5-18 MHz linear probe. Statistically significant differences were observed for the elasticity index (EI) between parathyroid and normal thyroid tissue (p<0.0001, U=291), and between parathyroid lesions and thyroid nodules (p<0.0001, U=248.5). An area under the curve (AUC) of 0.961, with an optimal cut-off value of ≤8.9 kPa, was established to effectively distinguish parathyroid tissue from normal thyroid tissue (sensitivity of 91.9%; specificity of 97.5%). Furthermore, an AUC of 0.963 and an optimal cut-off of 9.24 kPa (sensitivity of 94.2%, specificity of 91.1%) were determined for parathyroid vs thyroid lesions. Elasticity values were significantly elevated in the cancer group compared to benign thyroid nodules (p<0.0001). Our findings suggest that 2D SWE PLUS is an effective tool in differentiating between thyroid nodules and parathyroid lesions, enhancing diagnostic performance in neck ultrasonography.Copyright © 2023 Stoian, Borlea, Taban, Maralescu, Bob, Schiller, Schiller and Neagoe.