The Diagnostic Value Of Multimodality And Multimodality Under Different Thyroid Backgrounds For Thyroid Nodules

Objective: To investigate the diagnostic value of multimodality,which includes the thyroid imaging reporting and data system(TI-RADS),shear wave elastrography(SWE),ultrasound-guided fine needle aspiration(US-FNA)cytological classification of Bethesda and detection of BRAF V600 E,and multimodality under different thyroid backgrounds for thyroid nodules.Method: The relevant data of thyroid nodules from the patients who underwent the classification of TI-RADS,determination of SWE modulus value Emax,US-FNA cytological classification of Bethesda and detection of BRAF in the department of ultrasound,Fujian Union Hospital from March 2016 to November 2018 were collected and statistically analyzed.Results:(1)The sensitivity and specificity of TI-RADS were 77.9% and 75.6% respectively,the results of which were highly subjective.The background of Hashimoto's thyroiditis and nodular goiter can make the positive rate higher.(2)The best diagnostic threshold of SWE modulus value Emax was 48.65 kPa and the sensitivity and specificity were 57.2% and 75.6%.The results were affected by the ultrasonic signs,and the Hashimoto thyroiditis background would increase the measured value.(3)With 96.7% sensitivity and 78.0% specificity,the results of cytological classification of Bethesda were objective and were not affected by clinical data or ultrasonic signs.But the positive rates of the nodules under the background of Hashimoto's thyroiditis and nodular goiter were higher than that in the normal background.(4)The sensitivity and specificity of BRAF V600 E were 68.4% and 97.6% respectively.The result associated with the invasive nature of malignant nodules but were not affected by thyroid background.(5)For multimodal diagnosis,the sensitivity was 98.4% and the specificity was 82.9%.The diagnostic efficacy was higher than that of single diagnostic method,but were affected by different thyroid backgrounds.(6)Malignant nodules of the thyroid with nodular goiter are more invasive.(7)The diagnostic sensitivity and specificity were 87.2% and 97.6%,respectively,for the multimodality of distinguishing thyroid background.The diagnostic efficacy was higher than that of the multimodality without distinguishing thyroid background,and more consistent with the principle of clinical treatment.Conclusion:(1)TI-RADS,SWE modulus value Emax,cytological classification of Bethesda and BRAF V600 E were of clinical value in the diagnosis of thyroid nodules,but were also insufficient in their use alone.(2)The diagnostic efficiency can be improved by using the multimodal method of assigning points to each examination method and calculating the total score,which was affected by the background of Hashimoto's thyroiditis and nodular goiter.(3)Malignant nodules of the thyroid with nodular goiter are more invasive.(4)The diagnostic efficacy of the multimodality of distinguishing thyroid background was higher than that of the multimodality without distinguishing thyroid background,and more consistent with the principle of clinical treatment.