The Value Of Combination Of TI-RADS With VTI And VTQ For Differential Diagnosis Of Thyroid Nodules

Objective: To explore the diagnostic efficacy of the Thyroid Imaging Reporting and Data System(TI-RADS)proposed by the American College of Radiology(ACR)in the identification of benign and malignant thyroid nodules,and to compare with the diagnostic efficacy of virtual touch tissue imaging(VTI)and virtual touch tissue quantitation(VTQ),to explore the clinical use of TI-RADS,VTI,VTQ alone and combined identification of benign and malignant thyroid nodules.Methods: A total of 128 thyroid nodules were selected from 82 patients who underwent thyroid surgery and confirmed by postoperative pathology in our hospital from February 2018 to October 2018.All nodules were examined by conventional ultrasound and color Doppler flow ultrasound,VTI examination,VTQ examination before surgery,and different scores were given according to different image features in ACR TI-RADS,VTI different scores were given according to different grades of elastography,VTQ different scores were given according to the average value of shear wave velocity(SWV)in different intervals,to analyze whether there were differences in ultrasound signs and scores between benign and malignant nodules.Taking the pathological diagnosis as the golden standard,the receiver operating characteristic curves(ROCs)were drawn,and the area under the curves(AUCs)were compared,and obtain the best cutoff value of different diagnostic methods.The score ? the cutoff value is classified as a malignant nodule,and vice versa into a benign nodule.According to the cut-off values,the sensitivity,specificity,accuracy,positive predictive value(PPV)and negative predictive value(NPV)of TI-RADS,VTI,VTQ and TI-RADS combined with VTI,TIRADS combined with VTQ diagnosis of benign and malignant thyroid nodules can be calculated and compared.Results: 1.The accuracy of diagnosis of benign and malignant thyroid nodules was 61.7%,71.1%,67.2%,67.2%,71.1%,respectively,with solid structure,very low echo,non-parallel orientation,irregular edge or extrathyroid invasion,and microcalcification as a single indicator.AUC are 0.581(P=0.118)?0.722(P<0.01)?0.690(P<0.01)?0.687(P<0.01)?0.730(P<0.01),respectively.2.ACR TI-RADS classification score,VTI score,VTQ score and TI-RADS combined with VTI score,TI-RADS combined with VTQ score of benign and malignant nodules are different,the average score of malignant nodules higher than benign nodules,the difference was statistically significant(P <0.01).3.AUC comparison of various diagnostic methods: TI-RADS combined with VTQ(0.911,P<0.01)> TI-RADS combined with VTI(0.886,P<0.01)> TI-RADS(0.885,P<0.01)> VTI(0.816,P<0.01)> VTQ(0.789,P<0.01).Conclusions: 1.Diagnostic efficacy is low with solid structure,very low echo,non-parallel orientation,irregular edge or extrathyroid invasion,and microcalcification as a single indicator for the diagnosis of benign and malignant thyroid nodules.2.Regardless of the scoring method used,the scores of benign and malignant thyroid gland were different,and the scores of malignant nodules were higher than those of benign nodules.3.The diagnostic performance of VTI and VTQ alone is not superior to the TI-RADS alone,but combined with TI-RADS can improve the diagnostic performance.TI-RADS combined with VTQ is obvious.