Value Of TI-RADS Combined With Contrast Enhanced Ultrasound In Differential Diagnosis Of Solid Hypoechoic Nodules On The Basis Of Multiple Nodular Goiter

Objective To investigate the diagnostic value of thyroid imaging reporting and data system(TI-RADS)combined with contrast enhanced ultrasound(CEUS)in differentiating solid hypoechoic nodules on the basis of multiple nodular goiter.Methods Sixty-five patients with thyroid solid hypoechoic nodules on the basis of multiple nodular goiter involving 70 nodules were examined by conventional two-dimensional ultrasound and CEUS respectively.All solid hypoechoic nodules were classified by TI-RADS based on two dimensional ultrasound features.The surgical pathological findings were taken as the gold standard,TI-RADS,CEUS and their combination in the diagnosis solid hypoechoic nodules with the receiver operating characteristic curve.To evaluate the value of TI-RADS combined with CEUS in differential diagnosis of solid hypoechoic nodules on the basis of multiple nodular goiter.Results TI-RADS of thyroid solid hypoechoic nodules in 4b and above is classified as malignant,the sensitivity,specificity and accuracy of TI-RADS for the diagnosis of malignant thyroid nodules were 90.24%(37/41),58.62%(17/29),77.14%(54/70),respectively.Most of the images of CEUSenhancement pattern for malignant thyroid nodules showed early hypoenhancement,advanced hypoenhancement,heterogeneous enhancement and no surrounding ring enhancement,the sensitivity,specificity and accuracy of the four patterns were 87.70%(36/41),82.76%(24/29),85.71%(60/70);82.93%(34/41),79.31%(23/29),81.43%(57/70);90.24%(37/41),68.97%(20/29),81.43%(57/70);95.12%(39/41),20.69%(6/29),64.29%(45/70),respectively 。 The sensitivity,specificity and accuracy of TI-RADS combined with CEUS in the diagnosis of thyroid solid hypoechoic nodules were 95.12%(39/41),82.76%(24/29),90.00%(63/70),respectively.The specificity and accuracy of TI-RADS combined with CEUS in the diagnosis of solid hypoechoic nodules were higher than that of TI-RADS(P<0.05).The area under ROC curve of TI-RADS,CEUS and their combination were 0.734,0.860,0.889,respectively.TI-RADS combined with CEUS diagnosis of highest value.Conclusion In the detection and follow-up of multiple nodular goiter,TI-RADS can give a preliminary and standard risk judgment on malignancy of solid hypoechoic nodules,and then using CEUS to further identify benign and malignant,TI-RADS combined with CEUS can improve the accuracy of solid hypoechoic nodules,and provide the basis for clinical treatment.