The Differential Diagnosis Application Value Of Multimodal Ultrasound Technologies In Thyroid Nodules

Objective To evaluate the qualitative diagnosis value of routine ultrasonic ultrasonographic performance in thyroid nodule; To explore the correction value of the contrast-enhanced ultrasound for the thyroid TI-RADS3, 4 class nodules; Analysis of the benign and malignant differential diagnosis value of thyroid nodules in the contrast-enhanced ultrasound enhancement pattern grading, the time intensity curve parameters and the acoustic touch organization quantitative technique(VTQ) analysis parameters, and do comparing and discussing.Methods 114 patients with 142 thyroid nodules were enrolled into this prospective study(the final pathology diagnosis was confirmed by thyroidectomy), including 121 thyroid nodules do the contrast-enhanced ultrasound examination, 96 thyroid nodules do The Touch organization quantitative technique examination. To evaluate the qualitative diagnosis value of routine ultrasonic ultrasonographic performance in 142 thyroid nodule; To explore the correction value of the contrast-enhanced ultrasound for the 95 thyroid TI-RADS3, 4 class nodules; Analysis of the benign and malignant differential diagnosis value of 96 thyroid nodules in the contrast-enhanced ultrasound enhancement pattern grading, the time intensity curve parameters and the acoustic touch organization quantitative technique(VTQ) analysis parameters.Results Of 142 nodules by chi-square analysis, boundary, shape, rear echo, calcification, aspect ratio, acoustic shadow, acoustic halo, CDFI had significant statistical significance in distinguishing benign and malignant nodules(P < 0.01). Boundary owes clear, irregular shape, microcalcification, aspect ratio > 1, rear with acoustic shadow, uneven thickness of the halo rings, clutter blood flow signals in the proportion of benign nodules were 21.9%(14/64), 42.1%(27/64), 1.6%(1/64), 14.1%(9/64), 18.8%(12/64), 1.6%(1/64), 10.9%(7/64);In the proportion of malignant nodules were 42.3%(33/78), 52.6%(41/78), 30.8%(24/78), 78.2%(61/78), 19.2%(15/78) and 14.1%(11/78), 44.9%(35/78); For 142 nodules, benign nodules in TI- RADS grading is mainly with 3 grade, Ultrasound assessment of the percentage, the actual percentage,respectively accounting for 60.9%, 68.4%. malignant nodules in TI- RADS classification is mainly with 4 a grade, Ultrasound assessment of the percentage, the actual percentage, respectively accounting for 59.0%, 61.0%. According to the ROC curve analysis, for 95 thyroid TI-RADS 3, 4 type nodules, conventional ultrasonic TI-RADS grading and contrast-enhanced ultrasound TI-RADS grading area under the curve were 0.639, 0.814 respectively, the cut off value was TI-RADS 4a type、TI-RADS 4a type respectively, evaluation of benign and malignant nodules of sensitivity and specificity were 45.3%, 80.0%(P > 0.05); 82.7%, 60%(P < 0.05) respectively. For 96 solid nodules, by the ROC curve analysis: in contrast enhancement pattern grade, centripetal enhancement pattern grade under the curve(maximum) area is 0.763, when the centripetal enhancement pattern score ≥2 points, the diagnosis sensitivity and specificity of malignant thyroid nodules(papillary carcinoma) is 83.3%, 66.7% respectively(P<0.01);The Time intensity curve parameter analysis: the analysis parameters RS-Ratio under the curve(maximum) area is 0.856, when the analysis parameters RS-Ratio≥0.93, the diagnosis sensitivity and specificity of malignant thyroid nodules(papillary carcinoma) is 76.7%, 90.9% respectively(P < 0.01), PI- Ratio, RT-Ratio, RT, PI analysis parameters the area under the curve is decreasing in turn; The Acoustic touch organization quantitative technique(VTQ) parameters,The analysis parameter SWV under the curve(maximum) area is 0.918, when the analysis parameter SWV ≥2.67(m/s), the diagnosis sensitivity and specificity of malignant thyroid nodules(papillary carcinoma) is 90.0%, 87.9%, respectively(P < 0.01).Conclusion The Conventional ultrasonogram has important value in distinguishing benign and malignant thyroid nodules;The contrast-enhanced ultrasound had the revised and improved identification value for the thyroid TI-RADS 3, 4 type nodules.; the Contrast-enhanced mode score, the time intensity curve and the VTQ multi modality parameters provide the basis for the differential diagnosis of thyroid nodules with multiple angles and multiple methods.