Application Value Of Fine Needle Aspiration,CT,MRI And Contrast-enhanced Ultrasonography In The Differential Diagnosis Of Benign And Malignant Thyroid Nodules

Objective: To evaluate the value of fine needle aspiration,CT,MRI and contrast-enhanced ultrasonography in the diagnosis of thyroid carcinoma,and to guide the clinical use of these tests to identify benign and malignant nodules.Methods: A retrospective analysis of the clinical data of 226 patients in the First Affiliated Hospital of Guangxi Medical University from August 2015 to November 2016,including 282 nodules confirmed by pathology(193 benign,89 malignant)and preoperative FNA / CT / MRI / CEUS data of them.The sensitivity,specificity,accuracy,positive predictive value,negative predictive value of thyroid cancer detection were analyzed by FNA,CT,MRI,CEUS and Two joint,respectively.And further comparison of diameter ≤ 1cm and diameter> 1cm nodules was conducted.Results: The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of FNA in diagnosing thyroid carcinoma were 78.95%,92.31%,87.93%,83.33% and 90.00% respectively.The above indexes of CTwere 40.32% 79.77%,67.50%,47.17%,74.83%.70.59%,82.76%,78.26%,70.59%,82.76% for CEUS.And 57.14%,66.67%,60.00%,80.00%,40.00%for MRI.Accuracy comparation: FNA vs CT,CEUS vs CT,there was no significant difference between them(P <0.05).CT vs MRI,CEUS vs FNA,CEUS vs MRI,there was no significant difference between them(P <0.05).Group A(≤1cm): The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of FNA in diagnosing thyroid carcinoma were87.5%,100%,92.86%,100% and 86% respectively.The above indexes of CT were 34.78%,84.62%,61.22%,66.67%,59%;60%,71.43%,65.85%,66.67%,65% for CEUS.Accuracy comparation: There was significant difference between FNA and CT(P<0.05).There was no significant difference between FNA and CEUS,CEUS and CT(P> 0.05).Group B(> 1cm): The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of FNA in diagnosing thyroid carcinoma were72.73%,90.91%,86.36%,72.73% and 90.9% respectively.The above indexes of CT were 45.71%,78.57%,70.75%,40.0% and 82% respectively.85.71%,89.74%,88.68%,75%,95% for CEUS.Accuracy comparation: There was significant difference between FNA and CT,CEUS and CT(P<0.05).There was no significant difference between FNA and CEUS(P> 0.05).Conclusion: In the identifiction of benign and malignant thyroid,the diagnostic efficacy of FNA is superior to CT.When nodules diameter ≤ 1cm,FNA diagnostic performance is better than CEUS;When nodules diameter >1cm,CEUS diagnostic performance is better than CT.The difference betweenCT and MRI was not statistically significant.