Elastografinin benign ve malign tiroid nodüllerinin ayırımındaki rolü

Yıl 2019, Cilt: 12 Sayı: 1, 7 - 12, 18.01.2019

Ergin Sağtaş , Semin Melahat Fenkçi , Şenay Topsakal , Furkan Ufuk , Pınar Çakmak Osman Alparslan

https://doi.org/10.31362/patd.401988

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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