Diagnostic Value Of Virtual Touch Quantification In Benign And Malignant Coexistent Nodules Of Hashimoto’s Thyroid

Objective: Discussion of diagnostic value of virtual touch quantification(VTQ) of Acoustic Radiation Force Impulse(ARFI) in benign and malignant coexistent nodules of Hashimoto’s thyroid. Acquisition of critical value of shear wave velocity of benign and malignant nodules. Acquisition of tissue hardness calculated by velocity quantification. Deduction of the nature of a tissue nodule by tissue hardness.Expectation of providing a new quantitative noninvasive index for identification of coexistent nodules of Hashimoto’s thyroiditis to avoid unnecessary biopsy or surgical injuries.Methods: VTQ was applied to examine shear wave velocity of normal thyroid,Hashimoto’s thyroiditis and benign and malignant coexistent nodules of women aged 30 to 49, establish reference ranges, and analyze whether this technique can be applied on diagnosis and differential diagnosis of benign and malignant coexistent nodules of Hashimoto’s thyroid.Results: 1. Reference ranges of shear wave velocity of normal thyroid of women aged30 to 39 and 40 to 49 are( 1.65±0.37m/s) and( 1.67±0.54m/s) respectively. The difference of the shear wave velocity of the two age groups was not statistically significant(P>0.05).2.Reference ranges of shear wave velocity of hyperthyroidism-type Hashimoto’s thyroiditis, normal-thyroid- type Hashimoto’s thyroid and hypothyroidism-t ype Hashimoto’s thyroiditis were(2.59±0.15m/s),(2.63±0.18m/s) and(2.94±0.18m/s)receptively. 3. The optimal critical point on the ROC curve was reached when the shear wave velocity ≥2.53 m/s. Its sensitivity and specificity to diagnosing Hashimoto’s thyroiditis were 87%and 100%respectively. Compared with normal thyroid, the shear wave velocity of Hashimoto’s thyroiditis was distinctly higher and their differences were statistically significant(P<0.05). 4. Shear wave velocities of benign and malignant coexistent nodules of Hashimoto’s thyroiditis were(2.87±0.41)m/s and(3.28±0.67)m/s respectively. Shear wave velocities of peripheries of benign and malignant coexistent nodules of Hashimoto’s thyroiditis were(2.56±0.23)m/s and(2.97±0.22)m/s respectively. Result differences of these four groups were not the same(P<0.05) withstatistical significance. 5. The indication range of shear wave velocity of the optimal critical value of the benign coexistent nodules of Hashimoto’s thyroiditis of women aged 30 to 49 was 2.79m/s, and its sensitivity and specificity of the diagnosis were87.1% and 95% respectively. The indication range of shear wave velocity of the optimal critical value of the malignant coexistent nodules of Hashimoto’s thyroiditis of women aged 30 to 49 was 2.89m/s, and its sensitivity and specificity of the diagnosis were93.9% and 76.7% respectively. 6. The shear wave velocity of optimal diagnostic critical value of benign and malignant coexistent nodules of Hashimoto’s thyroiditis was3.09m/s and its sensitivity and specificity of the diagnosis were 81.6% and 84%respectively.Conclusion: VTQ could be used to test the shear wave velocity of normal thyroid of women aged 30 to 49 with good repeatability; the shear wave velocity of Hashimoto’s thyroiditis of women aged 30 to 49 was higher than that of normal thyroid and VTQ could be used to identify Hashimoto’s thyroiditis; the shear wave velocity of the group of the benign coexistent nodules of Hashimoto’s thyroiditis was higher than that of the benign nodule periphery group. The shear wave velocity of the group of the malignant coexistent nodules of Hashimoto’s thyroiditis was higher than that of the malignant nodule periphery group. There are differences among these four groups. VTQ could be used to assess with certain clinical diagnostic significance. The critical value of shear wave velocity of benign and malignant coexistent nodules of Hashimoto’s thyroiditis was obtained by establishing a receiver operating characteristic(ROC) curve, which was 3.09m/s.