Differential diagnosis value of ultrasound elastography in Hashimoto's thyroiditis with benign and malignant nodules

Objective To investigate the differential diagnosis value of ultrasound elastography in Hashimoto's thyroiditis with benign and malignant nodules. Methods From January 2013 to December 2015, 21 patients(25 nodules) with Hashimoto's thyroiditis and malignant nodules and 52 patients(76 nodules) with benign nodules in Jiangshan Hospital of Traditional Chinese Medicine were studied.All nodules were detected by color Doppler ultrasound and ultrasound elastography. Results The proportion of boundaries clear, morphological rules, non-low-echo, no calcification or coarse calcifications, RI value <0.70, blood flow grade 0-Ⅰin patients with malignant nodules(32.0%, 24.0%, 12.0%, 40.0%, 32.0%, 24.0%) were lower than those of the benign group(80.3%, 51.3%, 47.4%, 97.4%, 60.5%, 51.3%)(χ2=20.245, 5.682, 9.928, 44.228, 6.153, 5.682, P=0.000, 0.017, 0.002, 0.000, 0.013, 0.017). The sensitivity, specificity and diagnostic accuracy of two-dimensional color Doppler ultrasound in diagnosing Hashimoto's thyroiditis with malignant and benign nodules were 68.0%, 75.0% and 73.2%, respectively.The ultrasound elastography ≥Ⅲ grade level was as the predictor of malignant nodules, the sensitivity, specificity and diagnostic accuracy of ultrasound elastography in diagnosing Hashimoto's thyroiditis with benign and malignant nodules were 88.0%, 69.7% and 74.3%, respectively.The ultrasound elastography strain rate ratio=5.13 was the cut-off point, the ultrasound elastography strain rate ratio in diagnosing Hashimoto's thyroiditis with benign and malignant nodules, the sensitivity was 76.0%, the specificity was 92.1%, the diagnostic accuracy was 88.1%. Conclusion Ultrasound elastography grading and ultrasound elastography strain rate have certain value in the differential diagnosis of Hashimoto's thyroiditis with malignant and benign nodule. Key words: Hashimoto disease; Thyroid neoplasms; Thyroid nodule; Ultrasounography; Sensitivity and Specificity