目的:甲状腺结节极为常见,患病率高达68%,然而只有7-15%是恶性的。许多结节需要监测,并使用二维超声(2DUS)。问题包括获取和标记图像的巨大工作量,以及由于操作员之间的差异很大,难以随时间比较结节的大小。不准确可能导致不必要的FNAC或恶性结节的漏诊。
方法:我们比较了两种技术:徒手平面2DUS与带有陀螺制导的徒手2DUS,随后使用软件进行三维重建。我们测量了结节和正常甲状腺的体积。
结果:我们发现具有陀螺制导的2DUS优于普通2DUS,因为产生了更高精度的3D重建。甲状腺叶的体积测量为8.42cm3±0.94,与正常平均体积相当接近。然而,软件测得的椭圆形结节的体积为8.69cm3±0.97,球形结节的体积为7.09cm3±0.79。由于结核的预期体积分别为4.24cm3和4.19cm3,测得的结节体积不准确.表征结节所需的时间从通常程序中的30分钟减少到不到10分钟。
结论:我们发现3DUS有望用于评估甲状腺结节的大小,具有研究其他TIRAD特征的潜力。具有陀螺制导的徒手2DUS显示出最有希望生产可靠的,甲状腺结节的准确和更快的三维重建。
OBJECTIVE: Thyroid nodules are extremely common, with prevalence rate up to 68%, yet only 7-15% of these are malignant. Many nodules require surveillance and 2-dimensional ultrasound (2D US) is used. Issues include the huge workload of obtaining and labeling images and difficulty comparing sizes of nodules over time due to large inter-operator variability. Inaccuracies may result in unnecessary FNAC or missed diagnosis of malignant nodules.
METHODS: We compared two techniques: freehand plain 2D US against freehand 2D US with gyroscopic guidance, both followed by 3D reconstruction using software. We measured the volume of nodules and a normal thyroid gland.
RESULTS: We found 2D US with gyroscopic guidance to be superior to plain 2D US as 3D reconstructions of greater accuracy are produced. The volume of the thyroid lobe measured 8.42 cm3 ± 0.94 was reasonably close to the normal average volume. However, the measured volume of the ellipsoidal nodule by the software is 8.69 cm3 ± 0.97 while the measured volume of the spherical nodule is 7.09 cm3 ± 0.79. As the expected volume of the nodules were 4.24cm3 and 4.19 cm3 respectively, the measured volume of the nodule was not accurate. The time taken to characterise nodules was reduced greatly from over 30 min in usual procedure to less than 10 min.
CONCLUSIONS: We find 3D US promising for evaluating size of thyroid nodules, with potential to study other TIRAD characteristics. Freehand 2D US with gyroscopic guidance shows the most promise for producing reliable, accurate and faster 3D reconstructions of thyroid nodules.