机构：[1]Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, Heilongjiang Province, China.[2]Department of Diagnostic Ultrasound and The National Key Discipline of Medical Imaging and Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.四川大学华西医院[3]Department of Ultrasound, Sixth People’s Hospital Affiliated to Shanghai Communication University, Shanghai, China.[4]Department of Ultrasound, First Affiliated Hospital of Xi’an Communication University, Xi’an, Shanxi Province, China.[5]Department of Ultrasound, Xijing Hospital Affiliated to The Fourth Military Medical University, Xi’an, Shanxi Province, China.[6]Department of Ultrasound, Third Affiliated hospital of Kunming Medical University, Kunming, Yunnan Province, China.[7]Department of Ultrasound, Tumor Hospital of Beijing University, Beijing, China.[8]Department of Ultrasound, Xiang-ya Hospital of Centre-south University, Changsha, Hunan Province, China.[9]Department of Ultrasound, Tumor Hospital Affiliated to Xinjiang Medical University, Urumqi, Xinjiang Province, China.[10]Department of Ultrasound, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China.中山大学附属第二医院[11]Department of Ultrasound, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing, China.首都医科大学附属安贞医院[12]Department of Ultrasound, People’s Hospital of Guangdong Province, 106 Zhongshan Second Road, Guangzhou, Guangdong, China.
Background An accurate diagnosis for high-suspicion nodules based on the 2015 American Thyroid Association (ATA) guidelines would reduce unnecessary invasive examinations. Elastography is a useful tool for discriminating benign and malignant thyroid nodules. The aim of this study is to investigate the diagnostic efficiency of elastography for high-suspicion thyroid nodules based on the 2015 ATA guidelines in the Chinese population. Methods Thyroid nodules with high-suspicion characteristics based on the 2015 ATA guidelines were subjected to conventional ultrasound (US) and ultrasound strain elastography (USE) examinations at 12 hospitals from 4 geographic regions across China. Cytology/histology of thyroid nodules was used as a reference method. Receiver operating characteristic (ROC) curves were plotted to evaluate the diagnostic performance of the elasticity score (ES) and strain ratio (SR). Logistic regression analysis was used to determine the predictors of malignancy. Results Overall, a total of 1445 thyroid nodules (834 malignant, 611 benign) from 12 centers were included in the final analysis. The areas under the curve of the ES and SR were 0.828 and 0.732, respectively. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the ES were 92.4, 60.7, 79.0, 76.3 and 85.5%, respectively, and those of the SR were 81.1, 50.1, 68.9, 65.9 and 67.9%, respectively. The combination of the Thyroid Imaging Reporting and Data System (TI-RADS) and ES led to a significant increase in the sensitivity and NPV (97.1 and 91.9%, respectively) compared with the TI-RADS alone. Logistic regression analysis showed that microcalcifications (OR = 5.290), taller than wide (OR = 12.710), irregular margins (OR = 10.117), extrathyroidal extension (ETE; OR = 6.412), the ES (OR = 3.741) and the SR (OR = 1.083) were independent predictors of malignant thyroid nodules. The sensitivity, specificity, accuracy, PPV and NPV of the ES were all superior in nodules >= 1 cm than in those < 1 cm (95.0% vs 90.4, 68.8% vs 56.8, 85.9% vs 74.4, 85.2% vs 69.9, and 87.8% vs 84.2%, respectively). Conclusions Elastography combined with the ES is a valuable tool for the assessment of high-suspicion thyroid nodules based on the 2015 ATA guidelines, especially in nodules >= 1 cm.
第一作者机构：[1]Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, Heilongjiang Province, China.
通讯作者：
推荐引用方式(GB/T 7714)：
Li Hairu,Peng Yulan,Wang Yan,et al.Elastography for the diagnosis of high-suspicion thyroid nodules based on the 2015 American Thyroid Association guidelines: a multicenter study[J].BMC ENDOCRINE DISORDERS.2020,20(1):doi:10.1186/s12902-020-0520-y.
APA：
Li Hairu,Peng Yulan,Wang Yan,Ai Hong,Zhou Xiaodong...&Tian Jiawei.(2020).Elastography for the diagnosis of high-suspicion thyroid nodules based on the 2015 American Thyroid Association guidelines: a multicenter study.BMC ENDOCRINE DISORDERS,20,(1)
MLA：
Li Hairu,et al."Elastography for the diagnosis of high-suspicion thyroid nodules based on the 2015 American Thyroid Association guidelines: a multicenter study".BMC ENDOCRINE DISORDERS 20..1(2020)
