| Revista: | Journal of the Mexican Federation of Radiology and Imaging |
| Base de datos: | |
| Número de sistema: | 000606797 |
| ISSN: | 2696-8444 |
| Autores: | Cuvertino, Eduardo R1 Gelman, Liliana1 Miras Miartus, Mirta2 Geres, Alejandra3 Cuvertino, María L3 |
| Instituciones: | 1Universidad Nacional de Córdoba, Facultad de Ciencias Médicas, Córdoba. Argentina 2Hospital de Niños de la Santísima Trinidad, Servicio de Endocrinología, Córdoba. Argentina 3Hospital de Niños de la Santísima Trinidad, Servicio de Radiología y Diagnóstico, Córdoba. Argentina |
| Año: | 2024 |
| Periodo: | Ene-Mar |
| Volumen: | 3 |
| Número: | 2 |
| Paginación: | 82-92 |
| País: | México |
| Idioma: | Inglés |
| Tipo de documento: | Artículo |
| Resumen en inglés | Introduction: Ultrasound (US) elastography for thyroid microcarcinomas has variable diagnostic performance. This study aimed to (1) define the elastographic features of thyroid nodules using two-dimensional shear-wave elastography (2D-SWE) and (2) evaluate the utility of combining conventional US, elastography-strain (E-strain), and 2D-SWE for improving diagnostic performance in thyroid micronodules. Materials and Methods: Patients with thyroid nodules were evaluated in a cross-sectional study with conventional US, E-strain, and 2D-SWE. Nodule stiffness, the presence of a perinodular halo, and the halo/nodule A/B index were evaluated using 2D-SWE. Three elastographic patterns were defined based on conventional US, E-strain, and 2D-SWE features. The pathological diagnosis was made by fine needle aspiration biopsy and confirmed by surgery. Results: We included 158 patients with 158 thyroid nodules: 64 micronodules 10 mm and 94 macronodules > 10 mm. Malignancy was confirmed in 58 (36.7%) of 158 nodules, of which 29 were thyroid microcarcinomas. Stiffness at a cutoff value of 23.5 kPa predicted malignancy. Notably, 21 (72.4%) of 29 microcarcinomas with a perinodular halo had a stiffness value of < 23.5 kPa. All microcarcinomas with a perinodular halo (n = 21, 100%) had an elastographic stiffness A/B index 1.3. A congruent elastographic pattern was defined as thyroid imaging reporting and data system (TI-RADS) 4 or 5, E-strain pattern 4 or 5, with a stiffness 23.5 kPa without a perinodular halo, and an A/B index < 1.3 by 2D-SWE. An incongruent elastographic pattern was defined as TI-RADS 4 or 5, E-strain pattern 4 or 5, and discordant findings on 2D-SWE with intrinsic thyroid nodule laxity (< 23.5 kPa), a rigid perinodular halo, and an A/B index 1.3. An atypical congruent elastographic pattern was defined as TI-RADS 4 or 5 with atypical findings on E-strain (pattern 1, 2, or 3), and 2D-SWE with intrinsic thyroid nodule laxity (< 23.5 kPa), a rigid perinodular halo, and an A/B index 1.3. Conclusion: Three elastographic patterns of thyroid microcarcinomas are proposed based on 2D-SWE features such as nodule stiffness, a perinodular halo, and an A/B index in combination with conventional US and E-strain. These elastographic patterns have not been described in the literature. |
| Disciplinas: | Medicina, Medicina, Medicina |
| Palabras clave: | Endocrinología, Oncología, Diagnóstico |
| Keyword: | Endocrinology, Oncology, Diagnosis |
| Texto completo: | Texto completo (Ver HTML) Texto completo (Ver PDF) |
