Role of Virtual Touch Tissue Quantification in Hashimoto's Thyroiditis

We investigated the role of the virtual touch tissue quantification (VTQ) technique in diagnosing Hashimoto's thyroiditis (HT) and in distinguishing various HT-related thyroid dysfunctions. Two hundred HT patients and 100 healthy volunteers (the control group) were enrolled. The diagnostic performance of VTQ in predicting HT was calculated as the area under the receiver operating characteristic curve (A_Z). The HT patients were further classified into three subgroups on the basis of serologic tests of thyroid function: hyperthyroidism, euthyroidism and hypothyroidism. Comparisons of shear wave velocity (SWV) between three subgroups were evaluated by analysis of variance. The mean SWV of the control group was significantly lower than that of the HT group (1.93?±?0.33?m/s vs. 2.32?±?0.49?m/s, p?<0.001). A_z was 0.734 with a cut-off value of 1.86?m/s for performance of SWV in distinguishing between HT and a healthy thyroid; the sensitivity and specificity were 82.5% and 50.0%, respectively. Mean SWV values in the three HT subgroups (hyperthyroidism [2.07?±?0.37?cm/s] vs. euthyroidism [2.20?±?0.40?cm/s] vs. hypothyroidism [2.49?±?0.46?cm/s]) were significantly different (p?<0.05). Our results suggest that VTQ is a promising technique for assessing HT and HT-related thyroid dysfunction.     

超声弹性面积比值法与声脉冲辐射力成像鉴别诊断甲状腺结节的对比研究

目的 对比评价超声弹性成像面积比值法(EIAR)及声脉冲辐射力成像(ARFI)在鉴别诊断甲状腺良恶性结节中的价值.方法 对65例患者共78个甲状腺结节进行EIAR和ARFI检测,以病理结果为金标准,构建EIAR与ARFI鉴别诊断甲状腺结节良恶性的ROC曲线,分析两者曲线下面积,并比较其敏感性和特异性.结果 EIAE曲线下面积(0.840)与ARFI曲线下面积(0.856)差异无统计学意义(P＞0.05);以EIAR值≥1.23、ARFI测值≥3.18 m/s为诊断临界值,诊断甲状腺恶性结节的敏感性、特异性分别为71.4％、86％和85.7％、74.0％.结论 EIAR与ARFI技术鉴别诊断甲状腺良恶性结节的价值无明显差别,但均对甲状腺良恶性结节的鉴别诊断具有重要作用.     

Preliminary Results of Acoustic Radiation Force Impulse (ARFI) Ultrasound Imaging of Breast Lesions

The aim of this study was to determine the appearance of breast lesions using acoustic radiation force impulse imaging (ARFI) and to correlate the ARFI values with the pathologic results. The area ratio (AR) and virtual touch tissue quantification (VTQ) values were analyzed in 86 patients (mean age 45.6 years, range 17-78 years) with 92 breast lesions (65 benign, 27 malignant; mean size 25.7 mm). The diagnostic performance of ultrasound (US) alone and US plus ARFI values were compared with respect to sensitivity, specificity and area under the curve (AUC) using a receiver operating characteristic curve analysis. The mean AR of the benign lesions (1.08 ± 0.21) differed from that of the malignant lesions (1.99 ± 0.63; p < 0.0001), as did the mean VTQ values (3.25 ± 2.03 m/s vs. 8.22 ± 1.27 m/s; p < 0.0001). In conclusion, ARFI provides quantitative elasticity measurements, which may complement B-mode US and potentially improve the characterization of breast lesions.     

Solid Hypo-echoic Thyroid Nodules on Ultrasound: The Diagnostic Value of Acoustic Radiation Force Impulse Elastography

The aim of the study described here was to evaluate the diagnostic performance of acoustic radiation force impulse (ARFI) elastography in the differential diagnosis between benign and malignant solid hypo-echoic thyroid nodules (SHTNs) on ultrasound. In this retrospective study, 183 histologically proven SHTNs in 159 patients were enrolled. Conventional US, as well as Virtual Touch tissue imaging (VTI) and Virtual Touch tissue quantification (VTQ) of ARFI elastography, was performed on each nodule. The VTI features of SHTNs were divided into six grades, where higher grades represent harder tissue. VTQ was expressed as shear wave velocity, where higher shear wave velocity values indicate stiffer tissue. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Youden index for ultrasound and ARFI were assessed. The 183 pathologically proven SHTNs included 117 benign and 66 malignant lesions. Nodules classified as VTI grades IV to VI were more frequently malignant (49/66, 74.2%) than benign (10/117, 8.5%) (p < 0.001). The mean shear wave velocity of VTQ for malignant SHTNs (mean ± standard deviation, 4.65 ± 2.68 m/s; range, 1.36–9 m/s) was significantly higher than that for benign SHTNs (2.34 ± 0.85 m/s, 0–5.7 m/s) (p < 0.001). The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Youden index were 27.3%–84.8%, 13.7%–89.7%, 39.3%–69.4%, 35.7%–60%, 61.5%–78.5%, and –0.015 to 0.37 for ultrasound; 68.2%, 76.9%, 73.8%, 62.5%, 81.1% and 0.451 for VTQ; and 74.2%, 91.5%, 85.2%, 83.1%, 86.3% and 0.657 for VTI, respectively. ARFI elastography performed at a superior level, compared with conventional ultrasound, in the differential diagnosis between malignant and benign SHTNs. The diagnostic performance of VTI is higher than that of VTQ.     

Comparative Study of Acoustic Radiation Force Impulse Imaging With Real-Time Elastography in Differential Diagnosis of Thyroid Nodules

The aims of this study were to evaluate whether acoustic radiation force impulse (ARFI) imaging of the thyroid gland and thyroid nodules yields reliable results and to compare the values of ARFI imaging with those of real-time elastography (RTE) in the differential diagnosis of thyroid nodules. RTE and ARFI were performed in 30 patients with 58 thyroid nodules. The results were compared with pathologic findings. Receiver operating characteristic curves were drawn to evaluate the diagnostic results. The area under the curve for RTE (0.78) was smaller than that for ARFI (0.94) (p < 0.01). ARFI imaging of thyroid tissue yields more reliable results than RTE.