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Objectives To assess the clinical value of elasticity contrast index (ECI) in differentiating malignant thyroid nodules from benign ones. Methods Conventional ultrasound and elastography with pulsation of the carotid artery used as the compression source were retrospectively reviewed on 175 patients (143 females and 32 males; mean ± SD age, 45.17 ± 11.45 years) with 236 solid nodules (113 malignant and 123 benign). All nodules were confirmed by fine-needle aspiration or surgery to be accurately diagnosed. Elasticity contrast index values were computed and used to quantify local stiffness contrast within a nodule as determined with elastography. Elasticity contrast index values between the malignant and benign groups were compared and then related with pathological results. Diagnostic performance of this method was evaluated with use of the receiver operating characteristic curve. Results Mean ± SD ECI values for malignant thyroid nodules were significantly greater than those for benign nodules (3.67 ± 1.20 vs 1.80 ± 0.74, P < 0.01). Area under the receiver operating characteristic curve of ECI values was 0.907 (95% confidence interval, 0.867–0.948), and the best cutoff point was 2.16, leading to a sensitivity of 90.3%, specificity of 82.9%, positive predictive value of 83.7% and negative predictive value of 91.2%. Conclusions Elasticity contrast index values can serve as a useful parameter in the differential diagnosis of solid thyroid nodules. With the use of ECI values, objective quantitative information on the tumor stiffness can be achieved to improve diagnostic confidence.

Background: Gestational diabetes mellitus(GDM) may increase the risk of cardiovascular disease, and accompany asymptomatic deterioration of the myocardial function. This study aims to identify the subclinical impact of GDM on maternal left ventricular function by two-dimensional speckle tracking echocardiography (2D-STE).Methods:We prospectively recruited 47 women with GDM and 62 healthy pregnant women who underwent transthoracic echocardiography (TTE) at 24 to 28 weeks of pregnancy.GDM diagnosis was in agreement with the IADPSG criteria. TTE was performed according to the criteria of the American Society of Echocardiography. Conventional echocardiographic data and 2D-STE parameters were compared between the two groups.Results:Age, gestational weeks, heart rate, and conventional echocardiographic parameters had no difference between the two groups.The average LV global longitudinal strain (LV-GLS) of GDM patients was lower than controls (18.14±2.53 vs. 22.36±6.33, p<0.001). The LA reservoir and conduit strain in patients with GDM were also significantly reduced (32.71±6.64 vs. 38.00±7.06, 20.41±5.69 vs. 25.56±5.73, p<0.001). However, there was no significant difference in LA contractile function between the two groups. In multiple regression analysis, LV-GLS and LA conduit strain independently associated with GDM. Conclusions:2D-STE could detect the subclinical myocardial dysfunction more sensitively than conventional echocardiography, with LV-GLS and LA conduit strain as independent indicators of the GDM impact on maternal cardiac function during pregnancy.