| Purpose: This study was designed to explore the application value of ultrasound multi-modal technology in the clinical diagnosis of thyroid nodules,and in order to provide effective inspection methods for improving the diagnostic efficiency of thyroid nodules.Methods:Through retrospective analysis of 78 patients who underwent surgical treatment in the thyroid surgery department of our hospital,total 81 thyroid nodules,routine ultrasound examination,TI-RADS classification,shear wave elastography and US-FNAB were carried out in sequence,and all nodules were confirmed by surgical pathology,16 cases were benign nodules and 65 cases were malignant nodules.All patients must undergo routine ultrasound examination first,based on the evaluation indicators of the thyroid imaging data report and scoring system(TI-RADS),such as whether the nodule is hypoechoic,nodule aspect ratio ≥ 1,and nodule to be checked,whether there is sand-like calcification,posterior echo attenuation,blood supply status,and check whether the patient’s neck has abnormally enlarged lymph nodes,comprehensive assessment and classification of thyroid nodules.And all nodules were examined by shear wave elastography and the Young’s modulus value was recorded in real time.Diagnostic criteria of elastography: malignant nodules are diagnosed as elastic strain ratio>1.90 or shear wave pressure>45.0Kpa.All suspicious nodules were examined by ultrasound-guided cytology(US-FNAB)in this hospital or outside hospitals.When the diagnosis result of US-FNAB is(1)papillary carcinoma is suspected(2)papillary carcinoma is difficult to rule out(3)papillary carcinoma is the result of cytology malignant,otherwise benign,if the material was not satisfactory,repeat the puncture once.All operations were jointly completed by two highly trained ultrasound doctors,and the unanimous judgment results can only be confirmed.If not,a third party will join them,and the final judgment results will be subordinate to the majority.Receiver operating characteristic(ROC)curves were drawn,measure the area under the curve,and evaluate the diagnostic efficacy of conventional ultrasound,TI-RADS grading,shear wave elastography,US-FNAB and ultrasound multi-modal technology for benign and malignant thyroid nodules.Results: 02.65 cases were malignant nodules,39 cases were hypoechoic in routine ultrasound examination,28 cases had unclear edges,50 cases with aspect ratio≥1,and 3 cases had echo attenuation in the back,with sand-like particles There were 38 cases with calcification,21 cases with abundant blood flow signal,and 5 cases with abnormal lymph node enlargement.The results of elastography were malignant(elastic strain ratio>1.90 or shear wave pressure>45.0Kpa)in 51 cases,ultrasound-guided fine needle aspiration in 4 cases of benign nodules,and 61 cases of malignant nodules.3.The AUC value of multimodal technology in the diagnosis of benign and malignant thyroid nodules is 0.810,which is higher than the AUC value of 0.768 in elastography and 0.738 in conventional ultrasound.The diagnostic efficiency is significantly improved,But lower than the AUC value of 0.902 in cytology under ultrasound guidance.Conclusion: Through conventional ultrasound examination technology,various characteristics of thyroid nodules can be visually seen,and the nodules can be graded by TI-RADS with reference to color Doppler blood flow imaging.Elastography is mainly based on the evaluation of the hardness of thyroid nodules to distinguish benign and malignant nodules.Ultrasound multi-modal technology composed of multiple methods can greatly improve the diagnostic efficiency of benign and malignant thyroid nodules.The fine-needle aspiration examination has been used as the preferred method for detecting suspicious thyroid nodules in clinical work.It provided strong evidence for the selection of treatment options for patients with thyroid nodules. |
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