Application Of Acoustic Radiation Force Impulse Imaging In Differential Diagnosis Of Benign And Malignant Thyroid Nodules

Objective:To investigate the clinical value of Acoustic Radiation Force Impulse Imaging(ARPI)in differential diagnosis of benign and malignant thyroid nodules.Methods:From October 2016 to March 2018,79 patients were hospitalized for treatment of thyroid nodules at the Fifth Affiliated Hospital of Kunming Medical University.There were a total of 80 nodules,and conventional ultrasound,VTI,and VTIQ examinationsof thyroid nodules were performed before surgery,and record thyroid nodules ultrasound signs,VTI elastic grading,and SWV mean values.According to the pathological group,there were 40 benign thyroid nodules(including 34 nodular goiters,6 thyroid adenomas),40 malignant thyroid nodules(including 36 papillary carcinomas and 4 follicular carcinomas).The differences in SVW Vmean values between benign and malignant thyroid nodules were compared by the t test.The differences in SYW Vmean values of benign and malignant thyroid nodules and surrounding thyroid tissues were compared.Differences in VTI elastic grading between benign and malignant thyroid nodules were compared by chi-square test.According to the VTI elastic grading and SWVmean values of benign and malignant thyroid nodules,the ROC curve was drawn.The best diagnostic cut-off value and the area under the ROC curve were obtained for the VTI elastic grading and SWVmean values of benign and malignant thyroid nodules.Statistical analysis sensitivity,specificity and total coincidence rate of six methods of conventional ultrasound,VTI,VTIQ,conventional ultrasound + VTI,conventional ultrasound + VTIQ,and conventional ultrasound +VTI + VTIQ for the differential diagnosis of benign and malignant thyroid nodules,compare six kinds Method sensitivity,specificity size.Results:(1)The sensitivity,specificity,and total coincidence rate of conventional ultrasound differential diagnosis of benign and malignant thyroid nodules were 77.5%,72.5%,and 75.0%,respectively.(2)The VTI elasticity grading of malignant thyroid nodules was higher than that of benign thyroid nodules,and the difference between them has statistically significant(?2= 48.08,P<0.05).The best diagnostic cut-off value for the VTI elastic grading of benign and malignant thyroid nodules was IV,the area under the ROC curve was 0.875,and the sensitivity,specificity,and total compliance rate were 87.5%,90.0%,and 88.8%,respectively.(3)The average SWVmean value of peripheral thyroid tissue at the same depth of malignant thyroid nodules was(2.51�0.19)m/s,the average SWVmcan value of peripheral thyroid tissue at the same depth of benign thyroid nodules was(2.42�0.26)m/s,and the difference between them has statistically significant(t=1.71,P>0.05).The average SWVmean value of benign thyroid nodules was(2.98�0.48)m/s,the average SWVmean value of malignant thyroid nodules was(3.94�0.83)m/s.The SWVmean value of malignant thyroid nodules was higher than that of benign thyroid nodules(t=6.33,P<0.05).The SWVmean value of malignant thyroid nodules was higher than that of peripheral thyroid tissue of the same depth(t=10.65,P<0.05).The SWVmean value of benign thyroid nodules was higher than that of peripheral thyroid tissue of the same depth(t=6.46,P<0.05).The best diagnostic cut-off value for the SWVmean value of benign and malignant thyroid nodules was 3.24m/s,the area under the ROC curve was 0.892,and the sensitivity,specificity,and total compliance rate were 90.0%,82.5%,and 86.3%,respectively.(4)The sensitivity,specificity,and total coincidence rate of differential diagnosis of benign and malignant thyroid nodules by conventional ultrasound + VTI were 95.0%,65.0%,and 80.0%,respectively;the sensitivity,specificity,and total coincidence rate of differential diagnosis of benign and malignant thyroid nodules by conventional ultrasound + VTIQ were 97.5%,60.0%,and 78.8%,respectively;the sensitivity,specificity,and total coincidence rate of conventional ultrasound + VTI + VTIQ in differential diagnosis of benign and malignant thyroid nodules were 97.5%,55.0%,and 76.3%,respectively.(5)The sensitivity,specificity of conventional ultrasound,VTI technique,VTIQ technique,conventional ultrasound +VTI,conventional ultrasound + VTIQ,conventional ultrasound + VTI + VTIQ were compared separately,except for the sensitivity of conventional ultrasound + VTIQ and conventional ultrasound + VTI + VTIQ The difference was not statistically significant.The sensitivity and specificity differences of the other two pairs were statistically significant.The higher sensitivity was the conventional ultrasound +VTIQ,the conventional ultrasound +VTI+VTIQ,and the higher specificity was the VTI technique.Conclusion:Conventional ultrasound is the main method for differential diagnosis of benign and malignant thyroid nodules.VTI and VTIQ techniques have high specificity in differential diagnosis of benign and malignant thyroid nodules.Conventional ultrasound combined with VTI and VTIQ techniques Can improve the sensitivity of ultrasound differential diagnosis of benign and malignant thyroid nodules,reduce the rate of missed diagnosis of malignant nodules.