Elastografinin benign ve malign tiroid nodüllerinin ayırımındaki rolü

Öz

Amaç: Ultrason elastografi tiroid nodüllerini değerlendirmeye yarayan non-invaziv ultrason tekniği olup dokunun sertlik ve elastikiyetini inceler ve baskı ile yumuşak dokuların sert dokulara göre daha kolay deforme olabilmesi prensibine dayanır. Dokunun deforme olabilme özelliği malign ve benign lezyonların ayırımında kullanılır. Bu çalışmanın amacı benign ve malign tiroid nodüllerini ayırmada elastografinin tanı değerini araştırmaktır.

Gereç ve Yöntem: Yüzyetmişüç hastada 173 tiroid nodülü ince iğne aspirasyon biyopsisi öncesi gri skala ultrasonografi ve elastografi ile incelenmiştir.  Elastografi sonuçları ince iğne aspirasyon biyopsisi sonuçları ile karşılaştırılarak, tiroid nodüllerine uygulanan elastografinin duyarlılık, özgüllük, pozitif ve negatif öngörü değerleri hesaplamıştır.

Bulgular: Histopatoloji sonuçları 162 olguda (% 93,6) benign, 11 olguda(% 6,4)  malign olan nodüller için elastografinin karsinom belirlemedeki duyarlılığı % 45,4, özgüllüğü % 55,5, pozitif öngörü değeri % 6, negatif öngörü değeri % 94 olarak bulundu. Bu değerlere göre elastografi benign ve malign tiroid nodüllerinin ayırımında  istatistiksel olarak anlamlı bulunmamıştır (p>0,005).

Sonuç: Bizim çalışmamızda tiroid nodüllerinin preoperatif tanısında elastografinin duyarlılık ve özgüllük değerleri önceki çalışmalara göre daha düşük bulunmuştur. Buna göre tiroid nodüllerinin değerlendirilmesinde biyopsi halen en güvenilir tanı yöntemi olarak geçerliliğini korumaktadır.

Anahtar Kelimeler

• tiroid nodülü,ultrasonografi,elastografi,ince iğne aspirasyon biyopsisi

The role of elastography in differantiating malignant from benign thyroid nodules.

Öz

Purpose: Elastography is a novel noninvasive diagnostic tool that is helpfull in the evaluation of the thyroid nodules. This technique examines the stiffness and hardness of tissue. With the principle that the softer tissue is easily deformed than the harder tissue under external compression, the deformability of tissue was applied to differentiate malignant from benign lesions. The aim of this study was to evaluate the diagnostic value of elastography in differentiating malignant from benign thyroid nodules.

Materials and methods: A total of 173 thyroid nodules were examined by gray scale ultrasonography and elastography before fine needle aspiration biopsy in 173 patients.  Sensitivity, specificity, positive and negative predictive values of elastography, have been determined by comparing elastography results with fine needle aspiration biopsy results.

Results: For thyroid nodules of which 162 were benign (93,6 %)   and 11  malignant (6,4 %) according to histopathology results; the sensitivity, specificity, positive and negative predictive values of elastography in identification of carcinoma were  45,4 %, 55,5 %, 6 % and 94 % respectively. According to these values elastography was not statistically significant in differantiating benign and malignant thyroid nodules (p>0,005).

Conclusion: In our study the sensitivity and specificity values of elastography in preoperative diagnosis of thyroid nodules were found to be lower in contrast to earlier reports. Our study suggests biopsy is still the most reliable method for the evaluation of thyroid nodules.

Anahtar Kelimeler

• thyroid nodüle,ultrasound,elastography,fine needle aspiration biopsy

Kaynakça

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