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Ultrasound Elastography Using Carotid Artery Pulsation in the Differential Diagnosis of Sonographically Indeterminate Thyroid Nodules

Title
Ultrasound Elastography Using Carotid Artery Pulsation in the Differential Diagnosis of Sonographically Indeterminate Thyroid Nodules
Author
박정선
Keywords
carotid artery pulsation; elastography; thyroid nodule; thyroid ultrasound
Issue Date
2015-02
Publisher
AMER ROENTGEN RAY SOC
Citation
AMERICAN JOURNAL OF ROENTGENOLOGY, v. 204, NO 2, Page. 396-401
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.
URI
http://www.ajronline.org/doi/abs/10.2214/AJR.14.12871http://hdl.handle.net/20.500.11754/22456
ISSN
0361-803X; 1546-3141
DOI
10.2214/AJR.14.12871
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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