Study On The Diagnostic Value Of Multimodal Ultrasound In HT With Suspected Thyroid Nodules

Objective: To explore the diagnostic value of contrast-enhanced ultrasound(CEUS)combined with elastography(EI)in TI-RADS 4 types of thyroid benign and malignant nodules in the background of Hashimoto’s thyroiditis(HT).Methods: A total of 92 patients with TI-RADS type 4 thyroid nodules under the background of Hashimoto’s thyroiditis confirmed by surgery and pathology were collected.A total of 100 thyroid nodules under the background of HT were collected.Preoperative ultrasound contrast and ultrasound elasticity were evaluated.The imaging contrast mode and elasticity score,and finally the pathological results of thyroid nodules as the gold standard,explore the diagnostic value of contrast-enhanced ultrasound,elastography and contrast-enhanced ultrasound combined with elastography for TI-RADS 4 types of thyroid nodules under the background of HT.Results: 1.The accuracy rates of conventional ultrasound,contrast-enhanced ultrasound,elastography,and combined diagnosis of thyroid nodules in the context of HT were 75.00%,92.00%,91.00%,and 94.00%,respectively;the misdiagnosis rates were 25.00%,8.00%,and 9.00%,respectively,6.00%;sensitivity were75.86%,98.28%,89.65%,89.66%;specificity were 73.81%,83.33%,92.85%,100.00%;positive predictive value were 80.00%,89.06%,94.54%,100.00 %;negative predictive values were 68.89%,97.22%,86.66%,87.50%;+LR were: 2.89,5.89,0.12,+∞;-LR were: 0.32,0.02,0.11,0.10;Youden index,respectively Are: 0.49,0.81,0.83,0.89;2.Kappa consistency analysis shows: Kappa values are: 0.33,0.83,0.82,0.87;the difference between contrast-enhanced ultrasound and combined diagnosis is statistically significant(P<0.05),elastography and The difference in combined diagnosis was statistically significant(P<0.05).3.ROC curve analysis: the angiography score 4 is divided into the critical point of diagnosis,the AUC is 0.90,the sensitivity,specificity,and accuracy are respectively 98.30%,83.30%,and 92.00%;the elastic score 3 is divided into the critical point of diagnosis,and the AUC is 0.95,accuracy,specificity,and sensitivity were91.00%,92.90%,and 89.70%,respectively;the combined score of contrast-enhanced ultrasound and elastography was 7 as the diagnostic critical point,and the AUC was 0.97.The accuracy,specificity,and sensitivity were 93.00%,respectively.,97.60%,98.30%.The sensitivity of the combined scoring method is the same as that of the contrast-enhanced ultrasound scoring method alone,and is higher than that of the elastography scoring method alone.The specificity and accuracy of the combined scoring method are higher than those of the single scoring method.The AUC of the combined scoring method is higher than that of the single scoring method,and the diagnostic efficiency is high.In terms of the diagnostic power alone,the differences were statistically significant(P<0.05).Conclusion: Contrast-enhanced ultrasound combined with elastography can improve the accuracy of TI-RADS 4 types of benign and malignant thyroid nodules under the background of Hashimoto’s thyroiditis.