A Study On The Assessment Of Virtual Touch Tissue Quantification And Ultrasoud-guided Fine-needle Aspiratiaon Biopsy For TI-RADS4Class Thyroid Nodules

Objective：To observer the value of virtual touch tissue quantification(VTQ) andultrasoud-guided fine-needle aspiratiaon biopsy (US-FNAB) in diagnosis of TI-RADS4class thyroid nodules．Material and Methods：A total of191patients with200TI-RADS4class thyroid nodulesnodules confirmed by pathology,preoperative accept the US-FNAB and VTQ check from March2013to March2014, were chosen to research object. The VTQ denoted by transverse shearwave velocity (SWV) and draw ROC curve to determine the optimal diagnostic point SWVvalue．VTQ positive diagnostic criteria: SWV value is greater than or equal to the bestdiagnostic point value.US-FNAB positive diagnostic criteria: cytologic diagnosis ofmalignant or suspicious malignant. US-FNAB+VTQ positive diagnostic criteria: US-FNABor one VTQ which is positive. Surgical pathology was the gold standard, and all threewere calculated sensitivity, specificity, positive predictive value(PPV), negativepredictive value(NPV), accuracy,and compared the diagnostic value.Results：Pathologically proven thyroid nodules included142malignant and58benignlesions. The mean SWVs of benign and malignant thyroid nodules SWV malignant noduleswere(2.80±1.46) m/s(range:0.92～9.00m/s) and (4.75±2.40) m/s (range:1.17～9.00m/s)respectively (P=0.000). Receiver operating characteristic (ROC) curveanalysis shows that the best analysis of the diagnostic cutoff value3.0025(take3.00m/s), the maximum area under the curve(AUC)was0.800(P=0.000). US-FNAB cytologydiagnosis of malignant91,45suspicious malignant, benign59, can not clear diagnosisof five. VTQ in diagnosis of TI-RADS4class thyroid nodules sensitivity, specificity,PPV, NPV, accuracy was74.65%(106/142),81.03%(47/58),90.60%(106/117),56.63%(47/83),76.50%(153/200). US-FNAB in diagnosis of TI-RADS4class thyroid nodules sensitivity, specificity, PPV, NPV, accuracy was90.14%(128/142)、86.21%(50/58)、94.12%(128/132)、78.13%(50/64)，89.00%(178/200). US-FNAB combined with VTQ indiagnosis of TI-RADS4class thyroid nodules sensitivity, specificity, PPV, NPV, accuracywas96.48%(137/142)、84.48%（49/58）、93.84%（137/146）90.74%(49/54)、93.00%(188/200)。Under VTQ, US-FNAB, US-FNAB+VTQ three largest area of the curve were0.778,0.873,0.879.US-FNAB+VTQ, US-FNAB and VTQ diagnostic value was statisticallysignificant (P <0.05), while both the diagnostic value of US-FNAB+VTQ and US-FNAB showedno statistically significant significance (P>0.05).Conclusion：US-FNAB check is a safe, economical and high accuracy of the method,and couldeffectively improve the accuracy of preoperative. US-FNAB combined with VTQ in TI-RADS4class thyroid nodules have high diagnostic value,and could help the detection ofpapillary thyroid carcinoma,while VTQ have certain value.