Dissertation
Dissertation > Medicine, health > Clinical > Diagnostics > Diagnostic Imaging > Ultrasonic diagnosis

Research Development of Real-time Shear Wave Ultrasound Elasticity Imaging on Thyroid

Author LiuRui
Tutor LuYongPing
School
Course Medical Imaging and Nuclear Medicine
Keywords Shear wave elastography Young’s modulus Thyroid Thyroid gland withdiffuse lesion Thyroid carcinoma
CLC R445.1
Type Master's thesis
Year 2013
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Part1Quantitative study of real-time shear wave ultrasound elasticity imaging on normal thyroidObjective:real-time shear wave elasticity imaging technology was used to carry out elasticity quantitative study on normal thyroid tissue and find the hardness range of normal thyroid tissue so as to provide the basis for the further abnormal disease diagnosis.Methods:150cases of subjects with normal thyroid diagnosed in the physical examination center of the Fourth Affiliated Hospital of Kunming Medical University were selected,20-78years old, mean47years old, among of whom,78male cases,23-78years old, mean48years old and72female cases,20-75years old, mean46years old. According to the age, all the subjects with physical examination were divided into5groups, Nl group:30subjects,20-30years old; N2group:30subjects,30-40years old; N3group:30subjects,40-50years old; N4group:30subjects,50-60years old; N5group:30subjects, more than60years old. ShearWaveTM real-time shear wave elasticity imaging ultrasound diagnostic apparatus of French Supersonic Imagine Company, with the function of real-time shear wave elasticity imaging, was used to exam the real-time shear wave elasticity imaging of thyroid tissue, detect the elasticity of thyroid tissue and the mean value, maximum value, minimum value and mean value of degree of dispersion of elasticity were recorded. Results:the mean value of normal range of thyroid elasticity imaging was (20.28±4.82) kPa, the maximum value was (27.58±6.77) kPa, the minimum value was (13.74±5.13) kPa and degree of dispersion was (3.04±0.91) kPa. According to gender, the difference of the mean value of elasticity and the maximum value between male group and female group was not statistically significant (P>0.05); Divided into5groups according to age, the total mean value and the maximum value of elasticity between groups had significant difference (P<0.05). The mean value of the normal people’s thyroid elasticity was negatively correlated with age (r=-0.438, P<0.01) and the maximum value of the normal people’s thyroid elasticity was negatively correlated with age (r=-0.359, P<0.01). Conclusions:this study found that the mean value and maximum value of elasticity of thyroid tissue has certain correlative relation with age; thyroid tissue of20-30group is harder than that of the subjects more than60years old; the growing of age has certain effect on the hardness of thyroid tissue; the hardness of thyroid tissue is not associated with gender.Part2Preliminary research and discussion of real-time shear wave on the diffuse lesion of thyroidObjective:real-time shear wave ultrasound elasticity imaging technique was used to measure the elastic modulus to reflect the elastic characteristics of normal thyroid tissue and thyroid diffuse lesion and determine whether there was difference among various diffuse diseases and evaluate the diagnostic value of this technique on thyroid diffuse lesions.Methods:93cases of patients with diffuse thyroid disease diagnosed in our hospital were selected,35male cases,58female cases, mean25-63years old. Among of them, there ware43cases of patients with hyperthyroidism,26cases with subacute thyroid and24cases with Hashimoto’s thyroiditis. Besides,150subjects with normal thyroid function in our hospital were selected. All the subjects with physical examination were performed conventional ultrasound, elimination of thyroid nodule; shear wave elasticity imaging examination was performed for all the subjects in order to obtain the mean value, maximum value, minimum value and degree of dispersion of quantitative elasticity of diffuse thyroid lesion tissue and normal thyroid tissue.Results:the mean value, the maximum value, the minimum value and degree of dispersion of normal group were (20.28±4.82kPa,27.58±6.77kPa,13.74±5.13kPa and3.04±0.91kPa), respectively. The mean value, the maximum value, the minimum value and degree of dispersion of hyperthyroidism group were20.66±4.50kPa,30.60±6.10kPa,12.95±5.35kPa and3.74±1.63kPa respectively. The mean value, the maximum value, the minimum value and degree of dispersion of subacute thyroid group were29.92±4.80kPa,40.82±6.79kPa,21.95±6.98kPa and4.24±1.14kPa, respectively. The mean value, the maximum value, the minimum value and degree of dispersion of Hashimoto’s thyroiditis group were33.15±11.46kPa,47.46±12kPa,20.82±10.71kPa,5.53±1.15kPa respectively. The differences of the mean value, the maximum value and degree of dispersion of elasticity between the normal group and hyperthyroidism group, subacute thyroid group, Hashimoto’s thyroiditis group were statistically significant (P<0.05). The difference of the mean value and the maximum value of elasticity between hyperthyroidism group and subacute thyroid group were statistically significant (P<0.05). The difference of the mean value, the maximum value and degree of dispersion of elasticity between hyperthyroidism group and Hashimoto’s thyroiditis group were statistically significant (P<0.05). The difference of the mean value, the maximum value and degree of dispersion of elasticity between subacute thyroid group and Hashimoto’s thyroiditis group were statistically significant (P<0.05).Conclusions:real-time shear wave ultrasound elasticity imaging can diagnose hyperthyroidism, subacute thyroid and Hashimoto’s thyroiditis and indirectly conclude the pathological changes process of thyroid to provide the reference for the clinical treatment, follow-up, judgment and prognosis. Part3Value of real-time shear value ultrasonic elasticity imaging on the differential diagnosis of benign and malignant thyroid noduleObjective:real-time shear value elasticity imaging technique was used to exam the elastic modulus of benign and malignant lesion of thyroid and ratio of mean value of nodules elasticity to the mean value of surrounding tissue elasticity (SWE-Ratio, SI) to evaluate the value of this technique on the differential diagnosis of benign and malignant thyroid lesion.Methods:73cases of patients with thyroid cancer diagnosed by biopsy or operation pathologically were selected,28male cases and45female cases, with98lesions, among of which,43malignant nodules (papillary thyroid carcinoma,39; papillary microcarcinoma,4) and55benign nodules (nodular goiter,43and thyroid adenoma,12). All the lesions were performed with real-time shear wave elasticity imaging examination to observe the elastic wave color map of lesions and obtain the mean value, the maximum value, degree of dispersion of quantitative elasticity, ratio of mean value of nodules elasticity to mean value of surrounding tissue elasticity.Results:mean value of modulus of elasticity, the maximum value, the minimum value, degree of dispersion of benign lesion were (23.43±6.76) kPa,(32.27±8.71) kPa,(3.37±0.68) kPa,(3.37±0.68) kPa, respectively, and the ratio of mean value of nodules elasticity to the mean value of surrounding tissue elasticity was (1.12±0.31); mean value of modulus of elasticity, the maximum value, the minimum value, degree of dispersion of malignant lesion were (42.15±16.62) kPa,(67.58±26.90) kPa,(3.37±0.68) kPa,(9.06±4.63) kPa, and the of mean value of nodules elasticity to the mean value of surrounding tissue elasticity was (2.14±0.96) The difference of the mean value and the maximum value of elasticity, the ratio of mean value of nodules elasticity to the mean value of surrounding tissue elasticity between benign nodule and malignant nodule were statistically significant (P<0.05). The area under the ROC curve of mean value, the maximum value of elasticity and the ratio of mean value of nodules elasticity to the mean value of surrounding tissue elasticity of malignant thyroid nodule were0.908,0.957, and0.921respectively, mean value of elasticity of30.2kPa, the maximum value of elasticity of46.9kPa and ratio of mean value of nodules elasticity to the mean value of surrounding tissue elasticity of1.38were taken as the cutoff point of diagnosis:the sensitivity, specificity, accuracy of mean value of elasticity were81%,86.7%,67.7%respectively; the sensitivity, specificity, accuracy of maximum value of elasticity were85.7%,92%and77.7%, respectively; the sensitivity, specificity, accuracy of ratio of mean value of nodules elasticity to the mean value of surrounding tissue elasticity were85.7%,83%and68.7%.Conclusion:comparing the elasticity imaging of module, elastic modular value, degree of dispersion and ratio of mean value of nodules elasticity to the mean value of surrounding tissue elasticity based on real-time shear wave elasticity imaging is expected to provide the basis for the differential diagnosis of benign and malignant thyroid.

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