| Objective:To assess whether the Real-time Tissue Elastography(RTE) can identify the diffuse thyroid disease. Method:From February to October 2014, we selected 156 patients with diffuse thyroid disease which had been diagnosed by clinic in our hospital as the patient groups. Among of them, 46 patients were Graves’ disease(GD), 94 patients were Hashimoto’s thyroiditis( HT), 16 patients were subacute thyroiditis(SAT). Besides,we selected 60 persons with normal thyroid as the control group. First of all, both conventional sonography and RTE were performed for all selected thyroid glands to obtain the elasticity grading and elastic parameters. Then, the results of conventional sonography and RTE were compared among groups, along with the correlation analysis between the MEAN values of pathologic thyroids and the laboratory parameters. Finally,based on clinical diagnosis, the optimal cut-off point of MEAN for identifying the diffuse thyroid disease was determined by receiver operating characteristic( ROC) curve analysis. A P < 0.05 was considered to be statistically significant.Result1.In the control group and GD group,that there were a multitude of greenspots with a paucity of red and blue color,which indicated that theelasticity imaging grading were primarily grade 1(26/60,36/46), but the differences were not statistically significant. In the HT group,the elastography map mainly showed to be blue-green, and the elasticity imaging grading were mainly grade 2(62/94).In the SAT group,the elastography map chiefly displayed to be blue, and the elasticity imaginggrading were principally grade 3 and grade 4(6/16,10/16). 2.When comparing the elastic parameters from the patient groups and thecontrol group, the MEAN values of these groups were GD group>control group>HT group>SAT group,and%AREA values of the Region ofinterest were SAT group > HT group> control group> GD group. There were statistically significant differences among all groups(P<0.05), butthe difference between GD group and control group(P>0.05). The MEAN values of each group were inversely proportionto %AREA(Pearson r coefficient=-0.947,P<0.001). 3.The MEAN values of the GD group were higher than that of the HT groupaccording to the AUC(AUC=0.958). When the optimal cut-off value of MEAN reached 119.6, GD was correctly diagnosed in 36 of the 46patients with 82.6% Sensibility and 96.8% Specificity.The MEAN values of the SAT group were lower than that of the HT group by the AUC(AUC=0.984). When the optimal cut-off value of MEAN was 60.6, SAT was correctly diagnosed in 15 of the 16 patients with 95.7% Sensibility and 93.3% Specificity. 4.In the control group,the color doppler flow imaging(CDFI) mainly showed as sparse color flow signals of spot and short-rod, and the color flow imaging grading was all grade 1(60/60).In the GD group,the CDFI imaging increased significantly with the partof “fire sign”, while the color flow imaging grading was predominantily grade 3 and grade 4(24/46,18/46). In the HT group,most of the CDFI increased significantly(79/94).In the SAT group,the CDFI with the lesions region was normal or slightly less while the normal region was normal or slightly increased, while the color flow imaging grading was mainly grade 1(12/16). 5.The vascular pulsation of thyroid is common in patients with GD, which coule be used as the characteristic indicator. 6.The MEAN values of diffuse thyroid disease including GD, HT, and SATrevealed a low positive correlation with the levels of FT3 and FT4, while the MEAN values revealed nonsignificant correlation with the levels of TSH, Tg Ab, and TPOAb. 7.The accuracy rate of conventional ultrasound in diagnosing GD, HT, orSAT was 78.3%, 85.1%, 87.5% respectively. However, the accuracy rates were increased to 91.3%, 93.6%, 100% respectively, when combined withRTE. Conclusion:RTE seems to be a useful method for assessment of diffuse thyroid disease. But it must be comprehensive analysis of the ultrasound imaging, and the conventional ultrasound imaging combined with RTE could have a higher accuracy of diagnosis. |
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