The Value Of Superb Microvascular Imaging For Diagnosis Of Thyroid

Objective: To analyze the characteristics of blood flow distribution and blood flow classification of thyroid nodules,and to explore the application value of microvascular imaging in the diagnosis of thyroid nodules.Methods: Methods 100 cases of thyroid solid nodule confirmed by operation and pathology: 40 thyroid papillary carcinoma,30 nodular goiter and 30 thyroid adenoma.SMI and CDFI were used to observe the blood supply and blood flow distribution of thyroid nodules after routine ultrasound examination and TI-RADS grading.The pathological specimens were performed to CD34 immunohistochemical staining to detect the expression of MVD.Chi square test was used to compare the differences between in thyroid nodules.Analysis of the relevance between MVD expression and two blood flow detection techniques of Adler classification of the relevance.The specificity,sensitivity and accuracy of TI-RADS classification,SMI and CDFI in the differential diagnosis of benign and malignant thyroid nodules.Results: 1.The pathological features were compared with TI-RADS,its diagnostic specificity 87.9%,sensitivity of 78.6%,and accuracy rate of 84.0%.2.The thyroid nodules to abundance of blood flow of poor consistency(K=0.36)for SMI and CDFI in two blood flow imaging techniques.Compared with CDFI,there was significant difference between SMI and blood flow in thyroid nodules,(X~2 =17.51,P<0.01).3.Papillary carcinoma,nodular goiter,adenoma MVD were 34.75±11.02 、46.77±14.38、59.30±13.97,(t=3.96,P<0.01),papillary carcinoma and nodular goiter,the difference was statistically significant(t=3.96,P < 0.01),papillary carcinoma and adenoma,the difference was statistically significant(t=8.22,P<0.01).4.The MVD value increased with the increase of SMI blood flow classification of thyroid nodules,and the two groups were positively correlated.Compared with CDFI,MVD and SMI correlation is better(r=0.66,P<0.01).5.Both SMI and CDFI showed that malignant nodules were mostly central type vascularization,benign thyroid nodules were mainly peripheral type and mixed vascular pattern.Compared with CDFI,the distribution pattern of SMI in benign and malignant thyroid nodules was significantly different in the central type(X~2 =4.08,P<0.05;X~2 =4.04,P < 0.05).However,there was no significant difference in the display rate of blood flow pattern,central type,mixed type and malignant nodules without flow type,peripheral type and mixed type.6.Edge type and mixed blood flow distribution pattern was diagnosed as benign thyroid nodules,central type blood flow distribution pattern was diagnosed as malignant thyroid nodules.The specificity,sensitivity and accuracy of CDFI and SMI in discrimination diagnosis of thyroid nodules were 82.0%vs72.0%,80.0%vs52.5%,83.3%vs81.7%.7.Compared with the diagnostic accuracy of TI-RADS or SMI alone,the accuracy of TI-RADS and SMI in the diagnosis of thyroid nodules was 92.0%.Conclusion: 1.The technique of micro vascular imaging is more sensitive to blood flow.The SMI has precisely value in diagnosis of benign and malignant thyroid nodules.2.The blood flow classification of the ultra-microvascular imaging technology can reflect the angiogenesis of thyroid nodules.3.The combination of TI-RADS and ultra-vascular imaging can improve the diagnosis accuracy of benign and malignant thyroid nodules.