Background/Objectives: Static image captures (SICs) are the prevailing methodology for documenting thyroid nodules (TNs) on ultrasound examinations. Ultrasound cine-loop (CL) video sequences of the thyroid enable the storage and review of the entire organ in PACS, analogous to sectional imaging modalities such as CT or MRI. Expanding on SIC, the collection of more extensive datasets is possible, with the potential to enhance diagnostic performance. However, there is an absence of reliable data concerning this process. Methods: This retrospective, tertiary care, single-center study included all patients with cytologically and histopathologically diagnosed TNs from 01/16 to 12/23. A standardized CL protocol was routinely acquired in addition to conventional SIC. The diagnostic performance of ACR and Kwak TIRADS was examined for both CL and SIC in a PACS. Advantages, challenges, and limitations of CL were analyzed. Conclusions: In total, 189 patients with 329 TNs (78% females, aged 54 ± 15 years; 76% diagnosed via surgery; 14% malignant) were included. On SIC, 58 TNs (18%) were not identified (all benign). When comparing CL with SIC, a strong correlation was observed for nearly all ultrasound features (echogenicity, composition, margin, and foci; eachp< 0.001) and both TIRADSs (eachp< 0.001). The diagnostic accuracy of CL was slightly superior, with maximum values of 85% for ACR and 87% for Kwak TIRADS, respectively. Rating confidence and image quality exhibited superiority on SIC (eachp< 0.001). The occurrence of image artifacts was more prevalent in CL (p< 0.001). The integration of cine loops into thyroid ultrasound was found to be a seamless process, thereby enhancing the risk stratification of nodules. Image quality impairments manifested more frequently in cine loops, while static image captures demonstrated higher levels of assessment confidence.
背景/目的：静态图像采集是目前超声检查中记录甲状腺结节的主流方法。甲状腺超声动态视频序列能够在PACS系统中存储并回顾整个器官的影像，其功能类似于CT或MRI等断层成像技术。相较于静态图像采集，动态视频序列可收集更全面的数据集，具有提升诊断性能的潜力，但目前尚缺乏关于该过程的可靠数据。方法：这项回顾性、三级医疗、单中心研究纳入了2016年1月至2023年12月期间所有经细胞学和组织病理学确诊的甲状腺结节患者。除常规静态图像采集外，研究还系统性地获取了标准化动态视频序列。在PACS系统中对动态视频与静态图像分别应用ACR和Kwak两种TIRADS分类系统的诊断性能进行评估，并分析了动态视频技术的优势、挑战与局限性。结论：研究共纳入189例患者的329个甲状腺结节（女性占比78%，年龄54±15岁；76%经手术确诊；恶性结节占14%）。静态图像中有58个结节（18%）未被识别（均为良性）。对比分析显示，动态视频与静态图像在绝大多数超声特征（回声性质、成分、边界及局灶性特征；各项p<0.001）及两种TIRADS分类结果（各项p<0.001）上均呈现高度相关性。动态视频的诊断准确度略优，ACR与Kwak TIRADS系统的最高准确度分别达到85%和87%。静态图像在评估置信度与图像质量方面表现更佳（各项p<0.001），而动态视频中图像伪影的出现频率更高（p<0.001）。研究表明，动态视频技术可无缝整合至甲状腺超声检查流程中，从而提升结节风险分层评估效能。动态视频虽更易出现图像质量损伤，但静态图像则展现出更高的评估可靠性。
Risk Stratification of Thyroid Nodules Using Ultrasound Cine-Loop Video Sequences
肿瘤(癌症)患者之家