Application Value Of Three-dimensional Power Doppler Imaging In The Diagnosis Of Thyroid Nodules

Objective: To explore the value of three-dimensional power Doppler imaging in the diagnosis and differential diagnosis of benign and malignant thyroid nodules.Methods: 138 cases of thyroid nodules(168 nodules) were confirmed by operation and pathology: 56 thyroid adenoma, 56 nodular goiter and 56 thyroid papillary carcinoma. These ultrasound imaging reports were extracted, and the TI-RADS diagnostic value of thyroid nodules and pathological results were compared. The difference of VI, FI, VFI value and the cut-off value of three kinds of diseases were compared and analyzed. According to 3, 4a, 4b grade nodules of the TI-RADS classification, combined with FI and FI+VFI, with the pathological results again, analysis and comparison of diagnostic accuracy, sensitivity, specificity.Results: 1.The characteristics of ultrasound images of thyroid nodules were classified by TI-RADS and compared with pathologic results. The diagnostic accuracy was 90.48%, sensitivity was 92.86% and specificity was 85.71%.2. The mean of VI(%), FI, VFI were significantly higher in the thyroid adenoma(22.63, 29.54, 7.07) than that of thyroid papillary carcinoma(14.48, 25.43, 3.64) and nodular goiter(9.19, 21.25, 1.90); By comparing VI, FI and VFI among the thyroid nodule groups in the T-test we got that P < 0.01.3. Drawing the receiver operating characteristic(ROC) curve of thyroid adenoma and nodular goiter by using of thyroid papillary carcinoma as reference respectively, we found that the optimal cutoff value of VI(%), FI, VFI in thyroid adenoma was 17.80, 26.86, 4.07, in nodular goiter was 9.30, 24.08, 2.02, and thyroid papillary carcinoma between the two.4. FI had the highest diagnostic value in the single index, with precision 76.19%, sensitivity76.79 % and specificity 75.89%; The area under the curve(AUC) was 0.76(95% confidence interval(CI) were 0.69, 0.84). The diagnostic value of the FI combined with VFI was the highest in the single index and multiple indices, with precision 88.62%, sensitivity84.61% and specificity 90.48%; The AUC was 0.88(95% CI were 0.80, 0.95).5.The thyroid nodules of TI-RADS 3, 4a, 4b combined with FI and FI+VF. And the results were compared with the pathological results. When 152 thyroid nodules were diagnosed with FI cut-off value alone, the accuracy rate for 82.24%, less than 89.47% of TI-RADS; in FI+VFI diagnosis, only 113 nodules both meet the FI cut-off value and meet thecut-off value of VFI, the accuracy rate was 92.92%, higher than 90.27% of TI-RADS. Combined with TI-RADS and vascular index at the same time the diagnostic accuracy rate was FI:98.68%, FI+VFI:100%.Conclusion: 1. Three-dimensional power Doppler quantitative vascular index FI and FI + VFI are of higher value in diagnosingbenign and malignant thyroid nodules.2. Three-dimensional power Doppler imaging technology combined with TI-RADS grading system could significantly improve the diagnostic accuracy of benign and malignant thyroid nodules, and reduce the misdiagnosis rate.