The Application Of Shear Wave Elastography Guided Fine Needle Aspiration Biopsy In The Diagnosis Of Thyroid Nodules

Objective Compared with ultrasound-guided fine needle aspiration biopsy(US-FNAB),explore the use of shear wave elastography(SWE)to assess the optimal targeting area of thyroid nodules,guide fine needle aspiration biopsy,improve the diagnosis of benign and malignant thyroid nodules.Methods From October 2017 to October 2018,108 patients with suspected thyroid malignant nodules were selected.All patients were confirmed by pathology.They were randomly divided into two groups by parity method.conventional ultrasound guided group(54cases),elastography guided group(54 cases).The conventional ultrasound-guided group underwent FNAB after two-dimensional ultrasound observation of the nodule condition.The elastography guided group first performed a routine ultrasound evaluation of the nodules,and then performed SWE.According to the SWE map,the FNAB was performed on the region with the highest Young’s modulus value,and the clear diagnosis rate of the two methods was compared.Based on the Bethesda criteria,the cytopathological diagnosis results of the two methods were compared,and then the cytopathological results were compared with postoperative pathological results.The sensitivity,specificity,accuracy,and accuracy of the two methods for diagnosing benign and malignant thyroid nodules were evaluated.Missed diagnosis rate,misdiagnosis rate,and draw receiver operating characteristic curve(ROC curve).Results(1)Based on the Bethesda criteria,the results of cytological examination between the conventional ultrasound-guided group and the elastography-guided group showed that the elastography-guided group significantly improved the diagnosis of Bethesda class II and class VI(class II benign lesions、class VI malignant tumors).The difference was statistically significant(P < 0.05).(2)Taking the postoperative pathological results as the gold standard,the sensitivity of the conventional ultrasound-guided group for diagnosis of benign and malignant thyroidnodules was 73.33%,specificity was 87.5%,accuracy was 79.63%,missed diagnosis rate was 26.67%,and misdiagnosis rate was 12.8.%.The sensitivity of the elastography-guided group was 90.63%,the specificity was 100%,the accuracy was 94.44%,the missed diagnosis rate was 9.38%,and the misdiagnosis rate was 0.The area under the ROC curve(AUC)of the two groups was 0.802 and 0.953,respectively,and the difference was statistically significant(P<0.05).Conclusion Compared with conventional ultrasound,SWE can objectively evaluate the relative hardness of nodules,more accurately locate the target area of puncture,and guide the thyroid nodules biopsy,which significantly improves the diagnostic accuracy.Shear wave elastography guided thyroid nodules fine needle aspiration biopsy has higher accuracy,and its diagnostic efficiency is significantly higher than conventional US-FNAB.