Application Value Of Conventional Ultrasound Combined With S-detect And Elastography In The Identification Of Benign And Malignant Thyroid Nodules

BackgroundThe incidence of thyroid cancer remains high,and ultrasound is currently the first choice for screening thyroid nodules.However,the human eye has limited ability to recognize the overlap between the sonographic features of some benign and malignant nodules,which is prone to low diagnostic efficacy.The recent development of artificial intelligence and elastography has further expanded the scope of conventional ultrasound diagnosis.In recent years,there were a few studies on the diagnostic efficacy of conventional ultrasound combined with artificial intelligence and elastography on benign and malignant thyroid nodules,hence a large number of clinical studies are needed to further investigate.ObjectiveTo investigate the value of conventional ultrasound combined with S-detect and elastography for the differential diagnosis of benign and malignant thyroid nodules.MethodsA total of 320 thyroid nodules that underwent ultrasound examination in Henan Cancer Hospital from March 2021 to March 2022 and met the inclusion and exclusion criteria were selected as the study objects.All patients underwent conventional ultrasound,Ultrasound elastography(UE),and S-detect.Conventional ultrasound was classified according to the Chinese-Thyroid Imaging Reporting and Data system(C-TIRADS),and UE was evaluated using the improved 5-point scoring method.S-detect analyzed the image according to the artificial intelligence analysis system,and the diagnosis of "probably benign" or "probably malignant" was given after the analysis.According to the pathological results,thyroid nodules were grouped to analyze the ultrasonographic characteristics of benign and malignant nodules,such as morphology,margin,composition,orientation,aspect ratio,internal echo,posterior echo,calcification and elasticity score.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of C-TIRADS classification(conventional ultrasound),the score of UE,the diagnosis of S-detect and combined diagnosis of thyroid nodules were calculated using the surgical pathology results as the gold standard.Kappa values were used to compare the consistency of different diagnostic methods with pathological results.Results(1)The results of surgical pathology showed that 138 of the 320 nodules were malignant and 182 were benign.There were statistically significant differences in the morphology,margin,composition,orientation,aspect ratio,internal echo,posterior echo,calcification and elasticity score between malignant and benign thyroid nodules(P≤0.001).(2)Using surgical pathology results as the gold standard,the sensitivity of conventional ultrasound,UE,S-detect,conventional ultrasound +UE,conventional ultrasound +S-detect and the combination of these three in the diagnosis of benign and malignant thyroid nodules were 70.29%,80.43%,88.41%,89.85%,92.03%,94.20%,respectively;the specificity were 70.33%,79.12%,86.26%,85.16%,88.46%,91.21%,respectively;the accuracy were 70.31%,79.69%,87.19%,87.19%,90.00%,92.50% respectively;the positive predictive value were 64.24%,74.50%,82.99%,82.12%,85.81%,89.04%,respectively;and the negative predictive values were 75.74%,84.21%,90.75%,91.72%,93.60%,95.40%,respectively.The diagnostic Kappa values of conventional ultrasound+S-detect + ultrasound elastography and conventional ultrasound+ S-detect were > 0.75,which showed the consistency of them were good.The diagnostic Kappa values of conventional ultrasound,UE,S-detect and conventional ultrasound+ UE were between 0.4and 0.75,with moderate consistency.Conclusion(1)Conventional ultrasound,Ultrasound elastography,and S-detect are all effective methods for the diagnosis of benign and malignant thyroid nodules;(2)S-detect is more effective than conventional ultrasound(C-TIRADS classification)alone;(3)Combined diagnosis can significantly improve the diagnostic efficiency of benign and malignant thyroid nodules.And the combined diagnostic efficacy of conventional ultrasound,S-detect and UE is the highest,which can provide valuable diagnostic basis for clinical practice and effectively reduce non-essential surgery or puncture biopsy.