The Morphology And Distribution Characteristics Of Coarse Calcification For The Diagnosis Of Thyroid Papilla-carcinoma Application Value Analysis

Objective:To investigate the morphology and distribution of crude calcification in papillary thyroid carcinoma nodules and its value in the diagnosis of benign and malignant,and to analyze the effects of different forms of coarse calcified nodules on the classification of ultrasound TI-RADS.Methods:178 patients with thyroid nodules were enrolled.All patients underwent thyroid ultrasonography in our hospital before operation.A total of 179 nodules were associated with coarse calcification,including 140 benign nodules and 39 malignant nodules(pathology was confirmed as papillary thyroid carcinoma,PTC).The crude calcification was divided into regular type and irregular type according to the form,and it was divided into peripheral type,central type and mixed type according to the distribution pattern.The statistical difference of the two parameters for diagnosing PTC was analyzed.Surgical pathology was used as a standard to compare the effect of regular and irregular coarse calcified nodules on the thyroid imaging reporting and data system(TI-RADS).Results:①n conventional gray-scale ultrasound,nodular aspect ratio≥1 and low echo were correlated with PTC(P<0.05),and OR(oddsratio)values were 70.491 and 4.843,respectively.The nodular aspect ratio≥1 had the greatest diagnostic value for PTC.The diagnostic sensitivity,specificity,NPV(Negative predative value)and diagnostic coincidence rates were 79.49%,87.86%,93.89%and 86.03%,respectively.②In the crude calcification morphology,irregular crude calcification was significantly correlated with PTC(P<0.001,OR:16.711),and the sensitivity,specificity,NPV and diagnostic coincidence rate of diagnostic PTC were 69.23%,67.14%,88.68%and 67.60%,respectively.③In the coarse calcification distribution,the irregular coarse calcification of the central was associated with PTC(P<0.05),and the regular coarse calcification of the peripheral distribution was associated with benign nodules(P<0.05)④In the joint diagnosis,irregular crude calcification combined nodular aspect ratio≥1 was the most valuable for the diagnosis of PTC(P<0.001,AUC=0.828)⑤The calcification morphology of TI-RADS was consistent with the pathological results of the rough calcified nodules(P<0.05),and the TI-RADS scores with regular coarse calcified nodules were often high.The pathological results were inconsistent(P<0.05).Conclusion:calcification morphology:irregular coarse calcification suggested a higher risk of PTC,calcification distribution:central irregular coarse calcification suggested a higher risk of PTC,peripheral type coarse calcification suggested a greater likelihood of benign nodules,joint diagnosis:irregular coarse calcification combined with nodular aspect ratio≥ 1 was of significant value in the diagnosis of PTC,TI-RADS score efficacy:the values of TI-RADS scores with regular coarse calcified nodules tended to be high,and the TI-RADS scores with irregular coarse calcified nodules were consistent with pathological results.