Diagnostic Value Of TI-RADS Combined With Ultrasound Guided Fine Needle Aspiration For Thyroid Microcarcinoma

Objective: The purpose of this study was to combine thyroid imaging reporting and data system(TI-RADS)and the ultrasound guided fine-needle aspiration cytology(US-FNAC)to evaluate benign and malignant thyroid micronode(TMN),which can improve the diagnostic sensitivity and specificity of thyroid microcarcinoma(TMC)and reduce the diagnostic surgury rate.Materials and Methods: A retrospective analysis of the clinical data of 72 patients with TMN.Collecting the clinical data that included the sex,age.Ultrasonography(US)image features of these thyroid nodules was analyzed,including nodules solid,obvious hypoechoic,unclear boundary,anteroposterior/transverse diameter(A/T)ratio ? 1,microcalcification,then classified these nodules by the TI-RADS.Collected the preoperative US-FNAC results.Divided into benign nodules group(N=31)and malignant nodules group(N=41)based on the postoperative pathological results.The enumeration data of all the paring factors in the two groups were analyzed by X2 test and the measurement data were analyzed by t test,P<0.05,the difference was statistically significant.Calculating and comparing the accuracy,sensitivity,specificity,positive predictive value and negative predict value of TI-RADS independent diagnostic,US-FNAC independent diagnostic and TI-RADS combined with US-FNAC diagnostic.Kappa consistency test was used to evaluate the consistency of postoperative pathological results with above three methods based on the postoperative pathological results.Kappa?0.75 indicates a good consistency,0.75> Kappa?0.4 indicates a general consistency,Kappa <0.4 indicates a poor consistency,P < 0.01,the difference was statistically significant.Results: There had significant differences of the sex and age between benign nodules group and malignant nodules group(P <0.05).TI-RADS results compared with postoperative pathological results,2 cases were false positive and 18 cases were false negative.The accuracy,sensitivity,specificity,positive predictive value,negative predictive value were 36.1%,56.1%,93.5%,92%,61.7%.US-FNAC results compared with postoperative pathological results,2 cases were false positive and 13 cases were false negative.The accuracy,sensitivity,specificity,positive predictive value,negative predictive value were 79.2%,68.3%,93.5%,93.3%,69%.TI-RADS combined with US-FNAC results compared with postoperative pathological results,1 case was false positive and 4 cases were false negative.The accuracy,sensitivity,specificity,positive predictive value,negative predictive value were 93.1%,90.2%,96.8%,97.4%,88.2%.The diagnostic value of TI-RADS combined with US-FNAC are higher than either of the both methods applied alone.The kappa value of TI-RADS combined with US-FNAC were 0.86,indicates a good consistency,the difference was statistically significant(P<0.01),while the Kappa value of TI-RADS and US-FNAC were 0.467,0.621,respectively,indicates a general consistency,the difference was statistically significant(P<0.01).Conclusion: TI-RADS combined with US-FNAC has high diagnostic value for differentiating malignant nodules from TMN,can greatly improve the diagnostic sensitivity and specificity of TMC and reduce the diagnostic surgury rate.