超微血管成像、超声弹性成像及细针穿刺活检对TI-RADS 4类甲状腺结节诊断的应用价值

目的:探讨超微血管成像(superb microvascular imaging,SMI)、超声弹性成像及超声引导下的细针穿刺活检(fine needle aspiration biopsy,FNAB)对甲状腺影像报告与数据系统(thyroid imaging reporting and data system,TI-...

Application value of superb microvascular imaging,ultrasound elastography and fine needle aspiration biopsy in the diagnosis of TI-RADS 4 thyroid nodules

ObjectiveTo investigate the application value of superb microvascular imaging(SMI), ultrasonic elastography and ultrasound-guided fine needle aspiration biopsy(FNAB) in the diagnosis of thyroid imaging reporting and data system(TI-RADS) 4 thyroid nodules.MethodsSixty-one TI-RADS 4 nodules in 54 patients were detected using SMI, ultrasonic elastography and FNAB before surgery.The results of postoperative pathology was set as the "gold standard", the application value of SMI, ultrasonic elastography, FNAB and combination of the three in the diagnosis of TI-RADS 4 thyroid nodules were analyzed and compared.ResultsAmong the 61 nodules, the results of pathology showed that 24 cases were benign, and 37 cases were malignant.In the diagnosis of thyroid nodules, the sensitivity, specificity and accuracy of SMI were 62.52%, 64.86% and 63.93%, respectively; the sensitivity, specificity and accuracy of ultrasonic elastography were 70.83%, 72.97% and 72.13%, respectively; the sensitivity, specificity and accuracy of FNAB were 83.33%, 83.78% and 83.61%, respectively; and the sensitivity, specificity and accuracy of combination of the three were 91.67%, 91.89% and 91.80%, respectively.The specificity and accuracy of combination of the three in the diagnosis of TI-RADS 4 nodules were higher than those of SMI, ultrasonic elastography and FNAB alone(P < 0.05 and P < 0.01).The differences of the sensitivity between combined diagnosis, and SMI, ultrasound elastography and FNAB alone in the diagnosis of TI-RADS 4 thyroid nodules were not statistically significant(P>0.05).ConclusionsSingle application of SMI, ultrasound elastography and FNAB in the diagnosis or benign or malignant TI-RADS 4 thyroid nodule has certain deficiencies.Combined use of the three can significantly improve the specificity and accuracy of the diagnosis of the nature of TI-RADS 4 thyroid nodules, which has high clinical value.