The Application Of Conventional Ultrasound Combined Ultrasonic Elastography In The Diagnosis Of Hashimoto’s Thyroiditis Complicated With Thyroid Carcinoma

Objective:To investigate the best cut-off point of strain ratio for diagnosis ofHashimoto’s thyroiditis(HT) complicated with thyroid carcinoma．Tocompare the value of conventional ultrasound, ultrasonic elastographystrain ratio method, conventional ultrasound combined ultrasonicelastography strain ratio method in the diagnostic of HT complicated withthyroid carcinoma.Methods:75nodules of62HT sufferers were examined by conventionalultrasound and ultrasonic elastosongraphy. At conventional ultrasoundexamination, the nodule shape、boundary、echo level、echo characteristic,internal calcification, posterior echo, with or without cervical lymph nodeenlargement and blood distribution were used as the observation targets，from multiple sections to observe and describe the nodules. The strainratio method was used to evaluate the ultrasound elastograms. The bestcut-off point of strain ratio (SR) was obtained using receiver operatingcharacteristic (ROC) curve analysis. T-test was used for comparingmeasurement data. SPSS17.0was used for statistical analysis. Results:1. The sensitivity、specificity、accuracy of conventional ultrasound inthe diagnosis of HT complicated with thyroid carcinoma were65.3%、79.6%、74.7%.2. The SR of HT complicated with benign nodules is2.29±1.36,theSR of HT complicated with malignant nodules is5.44±2.59.The SR ofmalignant thyroid nodules was significantly higher than benign nodules,there was statistically significant (p＜0.01). Draw ROC curve and theAUC is0.863±0.047, the best cut-off point of SR was3.945. Thesensitivity、specificity、accuracy of ultrasonic elastography strain ratiomethod in the diagnosis of HT complicated with thyroid carcinoma were76.9%、85.7%、82.7%.3. The sensitivity、specificity、accuracy of conventional ultrasoundcombined ultrasonic elastography strain ratio method in the diagnosis ofHT complicated with thyroid carcinoma were92.3%、79.6%、84.0%.4. ROC curves: the AUC of conventional ultrasound、ultrasonicelastography strain ratio method and conventional ultrasound combinedultrasonic elastography strain ratio method were0.725、0.813and0.859,the three kinds of diagnostic mothod had high diagnostic value and thediagnosic value of conventional ultrasound combined ultrasonicelastography strain ratio method is the highest. Z-test was used forcomparing the AUC of the three kinds of diagnostic mothod，there was statistically significant between conventional ultrasound combinedultrasonic elastography strain ratio method.Conclusion:1. The ultrasonic elastography strain ratio method reflects therelative hardness of HT complicated with nodules objectively in asemiquantitative way, which has higher diagnosic value.2. The value of conventional ultrasound combined ultrasonicelastography strain ratio method in the diagnostic of HT complicated withthyroid carcinoma is superior to conventional ultrasound、ultrasonicelastography strain ratio method.