Modern aspects of ultrasound elastography in differential diagnosis of nodular thyroid neoplasms

Serova N.S., Evseeva E.V.

Purpose. The aim of this work was defining informative value of multi-parametric ultrasound examination using ultrasound elastography in differential diagnosis of thyroid nodular neoplasms.

Materials and methods. The work is based on outcomes of multi-parametric ultrasound examination of 229 persons in preoperative preparation stage in order to assess the effectiveness of using strain elastography (SEG) and shear wave elastography (SWE) on the example of ARFI and Strain Ratio. 3 patient groups were formed: the first group (N1=93) – patients with thyroid cancer, the second  group (N2=67) – patients with with benign nodular thyroid neoplasms (adenomas) and third group (N3= 67) – with benign thyroid nodules. Tissues elasticity during SEG was displayed in color mapping. Shear wave elastography (SWE) was used in ARFI and Strain Ratio modes; it was carried out on ultrasonic apparatuses Acuson S-2000 (Siemens, Germany), Ultrasonix SP (Sonix, Canada), Mindray DC-8 (Mindray, China).

Results. Color image of nodules and tumors and digital sonoelastometry (ARFI and strain-ratio) allow us to assume the probabilistic nature of the morphological structure of thyroid nodules with a high degree of probability. KEG is a test with good quality (AUC=0.784, sensitivity = 78.0%, specificity = 79.0%), but worse that the diagnostic indicators of the international system TIRADS and domestic TLA_RU. The use of the digitization of the image (ARFI) improves the results of diagnosis (AUC = 0,815, sensitivity = 83,8%, specificity = 79.1%). The combined use of the CEG and elastometry allows you to achieve better results in the diagnosis (AUC = of 0,902, sensitivity = 91,6%, specificity = 88,2%).

Conclusion. The complex use of sonoelastography techniques is highly informative modern technology, based on the assessment of various options for assessing the density of tissue of thyroid nodules and should be used primarily in suspected tumor lesion of thyroid, as well as to clarify the size of the nodes and detect tumor invasion in the surrounding tissue from the position of disease prognosis.

1 - I. N. Ulianov Chuvash State University.

Cheboksary, Russia.

2 - Republican clinical oncological dispensary. Cheboksary, Russia.

3 - Kazan State Medical Academy – branch of Russian Medical

Academy for Continuing Professional Education. Kazan, Russia.

4 - V.I. Kulakov National Medical Research Center for Obstetrics,

Gynecology and


Moscow, Russia.

5 - Yaroslavl state

medical University.

Yaroslavl, Russia.



Keywords: thyroid nodule, thyroid cancer, multi-parametric ultrasound examination, compression elastography, shear wave elastography, mathematical modeling.

Corresponding author:  Timofeeva L.A., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript


For citation: Timofeeva L.A., Sencha A.N.,  Tukhbatullin M.G., Shubin L.B. Modern aspects of ultrasound elastography in differential diagnosis of nodular thyroid neoplasms . REJR 2019; 9(2):141-149. DOI:10.21569/2222-7415-2019-9-2-141-149.


Received:        08.05.19 Accepted:       14.06.19