الفهرس 
Magnetic ResonanceOnly 14 pages are availabe for public view
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Abstract
Abstract Background: Thyroid nodule definite characterization is usually done using
a fine needle aspiration cytology/biopsy. The aim of this study was to evaluate the role of
ultrasound strain elastography & diffusion weighted imaging to differentiate benign from
malignant thyroid nodules.
Methods: Our study is a prospective. 59 patients (20 males and 39 females, mean age
37.9 years) with 59 thyroid nodules were included in the study. Conventional ultrasound,
ultrasound strain elastography and diffusion-weighted MR imaging with its quantitative
parameter apparent diffusion coefficient (ADC) were done for all cases. Histopathological
samples results were the standard reference.
Results: We found that ACR TI-RADS scoring system had (80 %) sensitivity ,(89.8%)
specificity and (84.9 %) diagnostic accuracy. Regarding the 4-points Asteria's criteria for
elastography score; we found that it had (70 %) sensitivity, (91.8 %) specificity and (80.9 %)
diagnostic accuracy. When a cutoff value of 1.65 was used for strain ratio; 90 % sensitivity,
71.4 % specificity and diagnostic accuracy of about 91.8 % noted. When a cutoff value of
1.45 x10-3 was used for ADC value; 80 % sensitivity, 95.9 % specificity and overall
accuracy of about 98% were detected. The best diagnostic performance was achieved in our
study by adding diffusion ADC value to the ACR TI-RADS with sensitivity 100%,
specificity 95.9% and accuracy 98% in differentiation of benign and malignant thyroid
nodules.
Conclusion: Strain elastography and diffusion ADC value enhanced diagnostic
performance of thyroid ultrasound. The best diagnostic performance was achieved by
adding diffusion ADC to the ACR TI-RADS.
Key words: Thyroid nodules, conventional ultrasound, ultrasound strain elastography ,
strain ratio , TI-RADS , diffusion-weighted magnetic resonance imaging , apparent diffusion
coefficient.