Learning objectives
The two main objectives of this project are to analyze whether the Shear
Wave elastography (SWE) improves the selection of thyroid nodules to be
referred for fine needle aspiration biopsy (FNAB) and to evaluate the patterns
obtained by the Shear Wave Elastography (SWE) of the thyroid nodules by
comparing them to cytology.
Background
In recent years,
elastography has been used as a new diagnostic tool
that uses ultrasound to evaluate the elasticity and stiffness of the lesions in
order to differentiate whether they are benign or malignant.
FNAB of all nodules identified on ultrasound would be unfeasible in any
health system.
Therefore,
criteria for increased risk were established through
conventional ultrasonography (mode B),
such as: nodule hypoechogenicity
(markedly hypoechogenic nodules has even greater association with
malignancy),
absence of hypoechoic peripheral halo,
presence of
microcalcifications,
anteroposterior diameter larger than...
Findings and procedure details
A total of 214 patients and 226 nodules were evaluated.
Nineteen nodules were excluded,
totaling: 207.
A region of interest (ROI) centered in the injury (including the largest
portion - without artifacts - that fits in the box) is selected.
The great cervical
vessels will be avoided.
The patient is instructed to not swallow and remain in
apnea during image register.
The deformation is represented by an elastogram that is formed by a
color scale superimposed on the B-mode image ranging from blue (e.g.
soft...
Conclusion
The results allow to conclude that 2D-SWE is an additional tool and can
be used as screening in the evaluation of thyroid nodules,
selecting those with average indexes of deformation above 2.91 m/s or 27.06 kPa,
referring them to fine needle aspiration biopsy (FNAB).
References
1.
Tan GH,
Gharib H.
Thyroid incidentalomas: management approaches to
nonpalpable nodules discovered incidentally on thyroid imaging.
Ann Intern
Med 1997;126:226-31.
2.
Topliss D.
Thyroid incidentaloma: the ignorant in pursuit of the impalpable.
Clin Endocrinol (Oxf) 2004;60:18-20.
3.
Goellner JR,
Gharib H,
Grant CS,
Johnson DA.
Fine needle aspiration
cytology of the thyroid,
1980 to 1986.
Acta Cytol 1987;31:587-90.
4.
M.
C.
Chammas et al.,
“Contribuição do duplex-Doppler colorido ao estudo
dos nódulos de tireoide” Otolaryngol.
Head.
Neck Surg.,
vol.
132,
no.
6,
pp.
874–882,...