The Diagnostic Value Of Optimized TI-RADS And Its Diagnostic Value Combine With BRAF V600E Mutation Gene In Thyroid Nodular Diseases

Part ?Purpose:Explore the ultrasonographic features of thyroid cancer and then optimize thyroid imaging and data reporting system(TI-RADS).As well as discuss its application value in the diagnosis of thyroid nodular diseases.Materials and Methods:The retrospective analysis of ultrasound images,clinical and surgical pathology data from 941 patients.The ultrasonic features and TSH levels of 1174 thyroid nodules were analyzed by chi-square test,nonparametric test and multi-factor logistic regression analysis.Screen out the valuable signs and bring them into the TI-RADS classification system.Also evaluate the diagnostic utility of the system.Result:The predictors of malignant thyroid nodules include hypoechogenicity,microcalcifications(including mixed calcifications),a taller-than-wide shapes,irregular edges(including vague borders,irregular shapes),and abnormal cervical lymph nodes.The sensitivity,specificity,positive predictive value and negative predictive value of the TI-RADS classification system were 72.8%,88.3%,78.3%and 84.9%,respectively,on the basis of malignant and benign ultrasonographic features of thyroid nodules.The ROC curve was constructed to give an area under the curve of 0.857.This classification system is more suitable for the diagnosis of nodules larger than 1 cm in size.Conclusion:The optimized TI-RADS classification system has good diagnostic value in judging the benign and malignant thyroid nodules,and the system is more suitable for the diagnosis of thyroid nodules larger than 1cm in size.Part ?Purpose:Explore the value of TI-RADS classification and BRAF V600E mutation gene in the diagnosis of thyroid nodular diseases.Materials and Methods:One hundred and thirty-one thyroid nodules were evaluated by TI-RADS classification system according to the method proposed in the first part.At the same time,some samples were collected to detect the mutation of BRAF V600E gene.All nodules eventually undergo US-guided fine-needle aspiration biopsy or postoperative pathological examination.Compare the diagnostic utility of TI-RADS classification system?the BRAF V600E mutation gene and the two methods.Results:The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of thyroid nodules were 81.8%,66.7%,48.5%,55.4%and 87.9%,respectively,by TI-RADS classification criterion.However,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of BRAF V600E mutation detection in thyroid nodules were 75.0%,94.3%,69.3%,88.6%,88.2%.The combination of the two methods can improve the diagnostic efficiency of TI-RADS classification increase the diagnostic sensitivity(97.7%),accuracy(62.0%),positive predictive value(58.1%)and negative predictive value(92.2%).However,there is a slight decline in the degree of specificity(66.7%?64.3%).Conclusion:The BRAF V600E mutation gene test can help improve the diagnostic performance of the TI-RADS classification.