| Objectives To analyze the sensitivity,specificity and accuracy of the diagnosis of thyroid nodules by using multimodal ultrasound,to explore the diagnostic value of using multimodal ultrasound to evaluate the nature of thyroid nodules.Methods From March 2018 to February 2020,79 patients who had undergone thyroid nodectomy in our hospital were selected,a total of 85 nodules.Before surgery,conventional ultrasound(US)examination was performed to observe the size,echo,boundary,morphology,calcification and other indicators of the nodules.Shear wave elastography(SWE)was performed to measure the Young’s modulus of thyroid nodules,including Emax,Emin,Emean,Esd,Eratio,etc.Contrast-enhanced ultrasound(CEUS)examination was performed to observe the enhancement characteristics of thyroid nodules and measured peak intensity(Peak),peak time(Tp),mean transit time(MTT),area under the time-intensity curve(AUCt)and other indicators by the time-intensity curve(TIC).Kolmogorov Smirnov was used to test whether the measurement data obeyed the normal distribution.The measurement data that follow the normal distribution are expressed by sx ±,using the independent sample t test,those that do not follow the normal distribution are expressed by the interquartile range M[P25-P75],using Mann-Whitney U test.The counting data is expressed by frequency or rate,and chi-square test is used for comparison.The receiver operating characteristic(ROC)curve was drawn with pathology as the gold standard to analyze the cut-off value of benign and malignant thyroid nodules.Using binary logistic regression analysis to analyze the ultrasonic parameters of US,SWE,CEUS and establish a regression equation to calculate the sensitivity,specificity,and accuracy.Results 1 General information: A total of 79 patients,aged 26～69 years,with an average age of 46.49 ± 12.54 years;including 85 nodules,with a nodule diameter of 0.24～3.97 cm and an average diameter of 0.67[0.48-1.12],of which are 44 benign nodules and 41 malignant nodules.2 US results: The malignant signs of thyroid nodules included hypoechoic,extremely hypoechoic,borderline fuzzy,aspect ratio >1,microcalcification in nodule and so on.The difference was statistically significant.3 SWE results: the Emax,Emin,Emean,Esd and Eratio of thyroid malignant nodules were higher than those of benign nodules,and the cut-off values were 36.2k Pa,26.1k Pa,32.6k Pa,3.05 k P,2.05 respectively.4 CEUS results: The enhancement characteristics of malignant nodule are inhomogeneous,centripetal and low enhancement,unclear boundary after enhancement,later than the enhancement of surrounding normal tissues,and earlier regression;in the time intensity curve,Peak and AUCt of malignant nodules were lower than those of benign nodules,and TP was later than that of benign nodules.5 Multimodal ultrasound: the sensitivity,specificity and accuracy of multimodal ultrasound are 90.2%、84.0% and 87.1%,respectively,which are higher than the other three independent inspection methods.Conclusions 1 Multimodal ultrasound has been able to integrate the sensitive indicators,evaluate the nature of thyroid nodules more accurately,increase the sensitivity,specificity and accuracy of ultrasound diagnosis of thyroid nodules,improve the diagnostic efficiency of thyroid nodules,with high diagnostic significance.2 The use of US,SWE and CEUS alone have certain clinical value in the diagnosis of benign and malignant thyroid nodules,but there are deficiencies.Figure8;Table18;Reference 130... |
