Evaluation Of Multimodal Ultrasound Technology Combined With Ultrasound-guided Fine Needle Aspiration In The Diagnosis Of TI-RADS Type 4 Thyroid Nodules

Objective: To investigate the evaluation of multimodal ultrasound technology(ultrasound elastography,contrast-enhanced ultrasound)combined with ultrasound guided fine needle aspiration(US-FNA)in the diagnosis of thyroid imaging reporting and data system TI-RADS 4 types of thyroid nodules.Methods: A retrospective analysis of 62 patients with thyroid nodules who were treated in Wuhu Hospital Affiliated to East China Normal University from September 2021 to September 2022,a total of 78 nodules diagnosed as TI-RADS category 4 by conventional ultrasonography,were performed preoperatively.Ultrasound elastography,contrast-enhanced ultrasonography,and US-FNA examination were used to analyze and compare the diagnostic efficacy of ultrasound elastography,contrast-enhanced ultrasonography,US-FNA examination,and the combination of the three in TI-RADS category 4 thyroid nodules with postoperative pathological results as the gold standard.Results: Among the 78 thyroid nodules,52 were malignant nodules and 26 were benign nodules confirmed by surgery and pathology.The sensitivity,specificity and accuracy of ultrasound elastography in diagnosing thyroid nodules were 63.46% 、 61.54%,and62.82%,respectively;CEUS were 71.15%、69.23%,and 70.51%;US-FNA was76.92%、88.46%,and80.77%.The combined diagnosis of the three is 92.31%、92.31%,and92.31%.The sensitivity,specificity and accuracy of combined diagnosis were higher than that of single examination,and the difference between combined diagnosis and US-FNA specificity was not statistically significant(p > 0.05),there were significant differences between the other groups(p < 0.05).Conclusion: The application of ultrasound elastography alone,contrast-enhanced ultrasound and ultrasound guided fine-needle puncture has certain diagnostic value for thyroid TI-RADS type 4 nodules,and the combination of the three has the highest diagnostic efficiency.