The Application Of Combined Ultrasonic Examination In The Differentiation Of Benign And Malignant Thyroid Nodules

Objective Explore preoperative was performed in patients with thyroid nodule TI-RADS classification,ultrasound elastography,contrast-enhanced ultrasound examination,compare their individual diagnosis and different combination method in diagnosis of benign and malignant thyroid nodule before surgery to identify the effectiveness and feasibility.Methods A total of 88 nodules were selected in our hospital from 76 patients.All patients underwent ultrasonic TI-RADS classification,acoustic contrast and ultrasound elastography three ultrasonic examination methods before operation.First,the three examination methods were used as diagnostic criteria alone,and then diagnosed in different combinations.The way is as follows,respectively two combination,namely the ultrasonic TI-RADS classification combined ultrasound elasticity imaging,ultrasonic TI-RADS classification combined ultrasonic imaging,ultrasound elastography in combination with ultrasound imaging,and both malignant diagnosis nodule at the same time,as a nodule in the diagnosis of malignant standard.Then in any of three methods of inspection of a malignant diagnosis nodule(series),with three methods of checking malignant diagnosis nodule at the same time(parallel method),as a nodule in the diagnosis of malignant standard.Finally,combined diagnosis was used to diagnose nodules at the same time with 2 or more examinations,and the nodules were considered as malignant,and the nodules were malignant.Ended with the pathological results as the gold standard for reference,statistics of a single check method and different combination method in diagnosis of sensitivity,specific,accurate,false positive rate and false negative rate.Results Separately using ultrasonic TI-RADS classification,ultrasound imaging and ultrasound elastography of benign and malignant thyroid nodule diagnosis sensitivity,specific,accurate,false positive rate and false negative rate were77.8%,77.0%,77.3%,23.0%,22.2%;88.9%,86.4%,92.0%,6.6%,11.1% and 85.2%,90.2%,88.6%,9.8%,14.5%.Ultrasonic TI-RADS classification combined ultrasound elasticity imaging,ultrasonic TI-RADS classification combined ultrasonic imaging and ultrasound elastography in combination with contrast-enhanced sonography is of benign and malignant thyroid nodule diagnosis sensitivity,specific,accurate,false positive rate and false negative rate were 63.0%,93.4%,84.1%,6.6%,37.0%;66.7%,98.4%,88.6%,1.6%,33.3% and 77.8%,95.1%,89.8%,4.9%,22.2%.In series,and even the diagnosis of benign and malignant thyroid nodule diagnosis sensitivity,specific,accurate,false positive rate and false negative rate were 100%,75.4%,83.0%,24.6%,0%;63.0%,98.4%,87.5%,1.6%,37.0%.Using the combined diagnosis,that is,the diagnosis of nodules is malignant by any two or more.The sensitivity,specificity,accuracy,false positive rate and false negative rate were 100%,91.8%,94.3%,8.2% and 0%.The sensitivity,specificity and accuracy were higher than those of the single diagnosis,and the accuracy was higher than that of the other combined diagnostic methods.The diagnostic efficiency compared with the other methods had statistical difference(P<0.05).Conclusion Combined use of ultrasound TI-RADS classification,ultrasound elastography and ultrasound contrast these 3 kinds of inspection technology,the combination of ultrasound imaging in two or more than two kinds of inspection diagnosis for malignant thyroid nodule at the same time,considering the nodules as malignant,and with two or more than two kinds of inspection and diagnosis of thyroid nodules are benign,considering the benign nodules.As the diagnosis of benign and malignant thyroid nodule standard,which can effectively increase the efficiency of the preoperative diagnosis of benign and malignant thyroid nodule and make effective guidance for clinical diagnosis and treatment,reduce the rate of surgery,has wide prospect of clinical application.