Clinical Application Of Ultrasonic Multimodality In The Diagnosis Of Thyroid Nodules

Objective:Screen the independent ultrasound risk signs of thyroid malignant nodules,analyze the application value of US,CEUS,SWE and ultrasound multimodality in the qualitative diagnosis of thyroid nodules,Explore the clinical significance of combined application of multi-modal ultrasound in the qualitative diagnosis of thyroid nodules.Methods:In this study,86 patients with 104 nodules were selected for FNA or surgery.the thyroid nodules were examined by US,CEUS,SWE before operation,and analyze the ultrasonographic signs of thyroid nodules.With pathological results as the standard.The ROC curve was plotted using the young's modulus of thyroid benign and malignant nodules,and the cut-off value of the young's modulus value was determined.The independent ultrasonographic signs of thyroid malignant nodules were screened by multiple factors Logistic regression analysis.Screen the independent ultrasound risk signs of thyroid malignant nodules,analyze the application value of US,CEUS,SWE and ultrasound multimodality in the qualitative diagnosis of thyroid nodules,compare the sensitivity,specificity and accuracy of the qualitative diagnosis of thyroid nodules.Results:1.The malignant signs of thyroid nodules in two-dimensional gray scale ultrasound include solid,hypoechoic or extremely low echo,irregular morphology,blurred borders,aspect ratio>1,micro calcification and suspicious lymph nodes.The malignant sign of color Doppler ultrasound of thyroid malignant nodules is the distribution of mixed vascular blood flow?The irregular signs of irregular shape,Vertical and horizontal ratio>1 and microcalcification are the independent risk signs of thyroid malignant nodules in conventional ultrasonography2.In contrast enhanced ultrasound,The malignant signs of thyroid nodules in sonography included centripetal enhancement,hypoenhancement,heterogeneous enhancement,and enhanced nodular border loss.The clearance time was earlier than that of peripheral thyroid tissue.Inhomogeneity enhancement,centripetal enhancement and clearance time were earlier than those of peripheral thyroid tissue is independent risk sign of thyroid malignant nodules.3.In elastography,the cut values of Young's modulus were 41.31 kpa,22.81 kpa,6.09 kpa,45.19 kpa,27.10 kpa and 4.48 kpa respectively.The SWE images of thyroid malignant nodules are mostly colourful,hard ring and lack of center.The maximum value of the longitudinal section >41.31 kpa,The classification of SWE images is independent and dangerous sign of thyroid malignant nodules.4.The independent ultrasound risk signs of thyroid malignant nodules are microcalcification,centripetal enhancement,maximum profile >41.31 kpa and SWE image classification.5.Diagnosis thyroid malignant nodule,Conventional ultrasound sensitivity was 82.0%,specificity was 81.5%,the accuracy rate was 81.7%;contrast sensitivity was 92.0%,specificity was 74.0%,accuracy rate is 82.7%;the elastic imaging sensitivity was 96.0%,specificity was 72.2%,accuracy was 83.6%;ultrasonic multi modal sensitivity was 96.0%,specificity was 92.0%,the accuracy rate was 93.9%.Conventional ultrasound sensitivity was 82.0%,specificity was 81.5%,the accuracy rate was 81.7%;contrast sensitivity was 92.0%,specificity was 74.0%,accuracy rate is 82.7%;the elastic imaging sensitivity was 96.0%,specificity was 72.2%,accuracy was 83.6%;ultrasonic multi modal sensitivity was 96.0%,specificity was 92.0%,the accuracy rate was 93.9%?Conclusion:1.The application of US,CEUS and SWE to the qualitative diagnosis of thyroid nodules has high clinical value,but there are some shortcomings.2.Ultrasonic multimodal combined application can improve the sensitivity,specificity and accuracy of the qualitative diagnosis of thyroid nodules.It has high application value and clinical significance.