Ultrasound in medicine & biology
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Ultrasound Med Biol · Jul 2019
Comparative StudyClinical Study of the Prediction of Malignancy in Thyroid Nodules: Modified Score versus 2017 American College of Radiology's Thyroid Imaging Reporting and Data System Ultrasound Lexicon.
The clinical importance of thyroid nodules rests with the need to exclude thyroid cancer. In the present study, we developed a modified Thyroid Imaging Reporting and Data System (TI-RADS) score using gray-scale ultrasound, contrast-enhanced ultrasound (CEUS) and shear-wave elastography (SWE) images to predict malignancy of thyroid nodules and compared this modified score system with the subjective scoring criteria based on the Thyroid Imaging Reporting and Data System (TI-RADS, 2017 edition). The results revealed that by using SWE and CEUS (enhanced pattern) to downgrade TI-RADS category 4 and 5 nodules, the malignancy rate for TI-RADS category 4 and 5 nodules increased from 47.6% with American College of Radiology (ACR) TI-RADS assessment alone to 49.4% with ACR TI-RADS combined with shear wave elastography (SWE) and CEUS (enhanced pattern). ⋯ With a point 4.5 as the optimal cutoff value, a score of 1 predicted malignancy with an accuracy of 75.6%, sensitivity of 85.0% and specificity of 71.6%. However, with a point 5.5 as the optimal cutoff value, a score of 2 predicted malignancy with an accuracy of 84.9%, sensitivity of 81.0% and specificity of 86.6%. The modified TI-RADS based on ACR TI-RADS + SWE + CEUS (enhanced pattern) could contribute to a reduction in the number of biopsies performed on benign nodules and the implementation of consistent follow-up in clinical practice.
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Ultrasound Med Biol · Jul 2019
Ultrasonic B-Line-Like Artifacts Generated with Simple Experimental Models Provide Clues to Solve Key Issues in B-Lines.
We evaluated the influence of settings on an ultrasound machine on the configuration of a single B-line in a healthy model and analyzed the frequency spectrum. We also devised simple experimental models that generated B-line-like artifacts and evaluated the influence of the machine settings on the configuration. Visualization of B-lines was affected by the spatial compound imaging, the focal zone and the frequency. ⋯ Visualization of B-line-like artifacts was also affected by these machine settings. Our study indicated that the physical basis of some B-lines is multiple reverberations. B-line-like artifacts provide clues for solving key issues, such as the physical basis of B-lines, the sonographic-pathologic correlation in B-lines and the effects of machine settings.