Clinical value of two-dimensional and color Doppler ultrasound combined with elastography in diagnosis of papillary thyroid microcarcinoma

He Meiting; Li Chunmei; Xing Yuanyuan

doi:10.3760/j.issn.1673-4777.2019.03.017

Abstract：Objective To analyze the clinical value of two-dimensional and color Doppler ultrasound combined with elastography in diagnosis of papillary thyroid microcarcinoma.Methods Clinical data of 41 cases of papillary thyroid microcarcinoma with 56 malignant nodules confirmed by post-surgery pathological examination from January 2014 to December 2016 in Beijing Anzhen Hospital,Capital Medical University were retrospectively analyzed.The patients were divided into observation group and control group according to different ultrasonic examination methods.In observation group(21 cases),28 nodules were detected by elastography,two-dimensional and color Doppler ultrasound;the control group (20 cases) had two-dimensional and color Doppler ultrasound and 28 nodules were found.Diagnostic accuracy for thyroid malignant nodules was compared between groups.Results There were 34 unilateral single nodules (60.7％) and 22 bilateral single or multiple nodules(39.3％).The smallest nodule was 2.0 mm × 2.0 mm × 3.0 mm and the largest one was 9.0 mm × 9.0 mm × 10.0 mm.Among the 56 nodules,2 nodules(3.6％) showed very low echo,50 nodules(89.3％) showed low echo,3 nodules (5.4％) showed solid-cystic echo and 1 nodule(1.8％) was iso-echo;6 nodules(10.7％) had clear boundaries and 50 nodules (89.3％) were unclear;9 nodules (16.1％) presented regular morphology and 47 nodules (83.9％) were irregular;53 nodules(94.6％) had aspect ratio-1 and 3 nodules(5.4％) had aspect ratio ＜ 1;3 nodules(5.4％) had coarse calcification and 53 nodules(94.6％) had micro-calcification.Diagnostic accuracy in observation group was significantly higher than that in control group[96.4％ (27/28) vs 75.0％ (21/28)] (P =0.002).Condasions Elastography can help to improve the diagnostic accuracy of papillary thyroid microcarcinoma in combination with two-dimensional and color Doppler ultrasound.Hypoechoic nodules with irregular shape,blurred border,angular border,lobulate and speculate border,multiple punctate and gravel-like microcalcification,aspect ratio≥ 1,elastography score 4-5 are characteristic changes of papillary thyroid microcarcinoma.