Analysis Of The Differential Diagnostic Value Of Composite Score For The Conventional Ultrasonographic Characteristics Of Thyroid Nodules

Objective To asses the value of the ultrasonographic characteristics and the composite score for differential diagnosis of thyroid nodules.Methods A total of 210 patients with thyroid nodules underwent surgical treatment in the hospital from July 2017 to December 2018 were selected as subjects.According to the postoperative pathological diagnosis results,the subjects were divided into the benign group and the malignant group.The ultrasound imaging signs of the two groups were observed and compared,and screen the significant different ultrasonographic characteristics of thyroid nodules identified by the univariate analysis,then binary logistic regression analysis was performed,and the receiver operating characteristic curve（ROC）was constructed,to made the extent of the weight scoring.Diagnosis of thyroid nodules by pathological examination as the gold standard of diagnosis,another receiver operating characteristic curve was constructed with the scores of thyroid nodules.The optimal critical score was determined with the biggestYouden index,and the sensitivity,specificity,positive predictive value,negative predictive value,accuracy,positive likelihood ratio and negative likelihood ratio were calculated.Results The conventional ultrasonographic characteristics of these nodules were analyzed and compared,include composition,echogenicity,shape,margin,A/T ratio,calcification and cervical lymph node enlargement.They were significant differentce between the benign nodules and the malignant nodules,and the extent of their scores were 15score～1 score,10 score～1 score,15 score～1 score,15 score～1 score,20 score～1 score,15 score～1 score,10 score～1 score,and the total scores was 100.The average score of the benign nodules was 45.422±10.69,and the average score of the malignant nodules was 66.63±6.55,P<0.05.Pathological diagnosis was the gold standard as the state variance,the score of every nodules as the test variance,the receiver operating characteristic curve was constructed,the area of the curve was 0.958,the best Youden index was 0.837,and the score was 56.5.The optimal cut-off for the diagnosis of composite score was 57,with a sensitivity of 94.33%,a specificity of 89.40%,a positive predictive value of 93.57%,a negative predictive value of 90.60%,a Youden index of 0.8373,an accuracy of 92.46%,a positive likelihood ratio of 8.8991 and a negative likelihood ratio 0.0634,Conclusion Suspected risk factors for the malignant nodulesincluded:the solid nodules,hypoecho,obscure boundary,irregular shape,A/T ratio≥1,microcalcification and cervical lymph node lesion.The sensitivity,specificity and accuracy based on the weight scoring for ultrasonographic characteristics of nodules in diagnosis of thyroid nodules are high,and the ultrasound characteristic diagnostic modelhas high efficiency in differentiating benign and malignant thyroid nodules.Only seven ultrasonographic characteristics are observed,the scores of every nodules are integers within one hundred,and are added upeasly.The application is helpful for clinicians to interpret the diagnostic evaluation of ultrasound for patients,depletes to depended on other inspection items,and thereby to make a reasonable treatment plan.So it has great practical value.