An analysis was made of the results of 111 patients,
which included the B-mode,
the modes of CD + PD,
RTE,
SWE.
They were divided into 2 groups: patients with focal and diffuse variations 56 (49.5%) and only focal variations 55 (50.5%).
46 (44.4%) nodular formations of solid and solid cystic structure 65 (58.6%) were analyzed.
Ultrasound signs of malignancy lesions in the study of gray scale are irregular shape,
vertical orientation,
contour roughness,
hypoechogenicity,
the presence of microcalcifications.
Some help in identifying the malignancy of the process has a study in the Doppler mode.
The presence and combination of these features allows to distribute the nodules in the categories TI-RADS 2-3 - (56.8%) and TI-RADS 4-5 - (43.2%).
According to the results of a combined study - compression and shear wave elastography,
fine-needle aspiration (FNA) biopsy and cytology were performed.
According to morphological results,
the following subgroups were formed: colloid goiter - 32 (28.8%),
adenomatous goiter - 5 (4.5%),
follicular adenoma –23 (20.7%),
autoimmune thyroiditis - 5 (4.5%) ),
thyroid cancer - 46 (41.5%).
The stiffness of the tissue with shear wave elastography of the nodes was distributed as follows: colloid goiter - E mean - 33.0 ± 19.4 kPa (2.4 ± 1.4 m/s),
the minimum - 19.4 and the maximum value – 54.4 kPa,
autoimmune thyroiditis - E mean -56.0 ±11.4 kPa (2.5 ± 1.7m/s),
the minimum - 22.8 and the maximum value - 86.0 kPa,
adenomatous goiter - E mean -47.8 ±10.4 kPa (2.6 ± 1.7m/s),
the minimum -31.6 and the maximum value - 89.0 kPa,
follicular adenoma - E mean - 62.0 ± 20.5 kPa (2.8 ± 1.8 m/s),
the minimum is -22.8 and the maximum value is –128kPa.
The threshold value of the malignancy lesions was E mean –82.6 ± 26.6 kPa (5.5 ± 1.7 m/s),
the minimum - 40.7 and the maximum value –180.0 kPa. Mean SWE,
Emean,
SWE –ratio (Emean1/Emean2) and the mean StR for the prediction of malignant thyroid nodules were ≥52,5Kpa (40.7-180.0 Kpa), 2,94±0.92 m / s,
2,62±1,4 и 5,91±1,54 (3,0),
respectively.
The real-time elastography (RTE),
the average SWE value and the mean StR value were 0,851,
0,862 и 0,842,
respectively (P> 0,05),
and the accuracy was 83,15,
80,50 and 80,26% respectively (P> 0,
05).
The accuracy of combined use standard sonography,
mean SWE and mean StR were 96,03,
93,39 and 95,71%,
respectively,
which was slightly higher than in conventional sonography (P> 0,05),
especially in patients with cystic-solid nodal formations.