Application Of Fine Needle Aspiration In TI-RADS3 And 4 Types Of Thyroid Nodules

Objective: To explore the value of fine needle aspiration(FNA)in the differential diagnosis of thyroid imaging reporting and data system(TI-RADS)between benign or malignant in thyroid nodules type 3and4,and to promote the rational TI-RADS classification of thyroid nodules.Methods: A retrospective analysis was made about ultrasound examination in the ultrasound diagnosis department of the First Affiliated Hospital of Nanjing Medical University.The ultrasound report indicated that there were thyroid nodules type 3 and 4(including 4A,4B and 4C subtypes)by TI-RADS in 337 patients(381 nodules in total)who simultaneously underwent fine needle aspiration.The cases with unsatisfactory pathological results were excluded and the eligible pathological results of 326 thyroid nodules were compared with the surgical pathological results.Results: In the 381 thyroid nodules type 3and4 by TI-RADS,76 were benign(including benign follicular nodules),44 were atypical of undetermined significance(AUS)with unclear significance.55 were dissatisfied,44 were suspiciously malignant,162 were malignant by FNA cytological diagnosis.As for surgical pathological results,119 were benign and 207 were malignant.The comparison between the results of FNA cytological diagnosis and pathology results were statistically significant(P < 0.001).The sensitivity,specificity and accuracy of FNA were 66.7%,97.7% and 95.7% for thyroid nodules type 3 by TI-RADS and 77.3%,95.2%,89.1%,95.8%,73.9%,90.4%,96.4%,72.7% and 94.3% for thyroid nodules type 4A,4B and 4C by TI-RADS.Conclusion: Thyroid fine needle aspiration has a high practical value in the diagnosis of benign or malignant thyroid nodules type 3and4 by TI-RADS,which is helpful to promote the rational TI-RADS classification of thyroid nodules and reduce the underestimation for thyroid nodules type 4A and 4B by TI-RADS.