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Investigation of the maximum Young's modulus of thyroid nodules using two-dimensional shear wave elastography in thyroid nodules

Objective: To investigate the maximum Young’s modulus (SWE-max) of thyroid nodules using twodimensional Shear Wave Elastography (2D-SWE) in thyroid nodules. Young's modulus is a measure of the stiffness of a solid material. It defines the relationship between stress (force per unit area) and strain (proportional deformation) in a material.

Materials and Method: A total of 244 patients with 289 nodules schedules for thyroid operation or fineneedle aspiration were recruited in our study. 2D-SWE examinations were performed after the greyscale ultrasound to get the maximum Young’s modulus of thyroid nodules, which were then correlated with pathology results. Then we investigate the distribution of the SWE-max by using logarithmic normal distribution. Finally we presented the association in differentiation the quality of thyroid nodules with the nodule’s SWE-max.

Result: The mean age was 45.58 ± 12.15 years old. Of all these 244 patients, 18 (7.4%) exhibited with multiple nodules and 226 (92.6%) presented with single nodules were included in this study. The mean diameter of 289 nodules was 12.7 ± 6.4 cm. If SWE-max ≥ 120 kPa, the nodule was highly suspicious for malignancy. If 120>SWE-max ≥ 69 kPathe nodule was suspicious for malignancy. It indicated that the possibility for malignancy was higher than benignancy. 69 kPa was considered as the expected value for malignant nodules. If 69 kPa>SWE-max ≥ 45 kPa, the nodule was indeterminate. If 45 kPa>SWE-max, the nodule was suspicious for benignancy.

Conclusion: 2D-SWE imaging can provide quantitative information about thyroid nodules’ stiffness. And the quantitative parameters are effective in differentiating benign and malignant thyroid nodules.

Author(s): Jing Hang, Hai-yan Xue, Hong-yan Deng, Xin-hua Ye, Cui-ying Li, Wen-ting Ma, Fan Li, Lianfang Du