The Application Of TI-RADS In The Diagnosis Of Thyroid Nodules

Objective:to analyze the ultrasonographic data of thyroid nodules in our hospital retrospectively,and to classify the thyroid nodules according to the Kwak classification standard of thyroid ultrasound image reporting system and data system(TI-RADS).To explore the value of TI-RADS grading system in the diagnosis of benign and malignant thyroid nodules,so as to provide evidence for clinical diagnosis of thyroid cancer.Methods:from January 2016 to December 2017,patients who were hospitalized in our department of thyroid surgery were selected.Two nodules were found in 11 patients and 195 nodules were found in 184 patients.The ultrasonographic features of 195 nodules were analyzed retrospectively,and the differences of ultrasonic features of different pathological types of thyroid nodules were compared.According to Kwak TI-RADS,the sonographicfeatures of thyroid nodules were compared with each other.The TI-RADS grading system was used to classify the benign nodules and the malignant nodules were diagnosed as benign nodules and malignant nodules by TI-RADS in grade 1-3 and grade 4-5,respectively.All data were statistically analyzed with SPSS 22.0,and univariate analysis was performed on the structure,shape,boundary,aspect ratio,edge,echo,hyperechoic lesion,hypocchoic halo and blood flow of benign and malignant thyroid nodules by chi-square test.The difference was statistically significant(P<0.05).The independent variables with statistical significance were analyzed by binary Logistic regression,and the likelihood ratio test was carried out.Diagnosis of thyroid nodules by pathological examination as the gold standard of diagnosis,the working curve of ROC was drawn,and the specificity,sensitivity,accuracy,negative predictive value,positive predictive value and area under curve of TI-RADS system were recorded.Results:two nodules were found in 11 of 184 patients,and one nodule was found in the other 173 patients.A total of 195 nodules were found.The pathological results showed that the proportion of thyroid nodules diagnosed as malignant nodules gradually increased with the increase of TI-RADS grade.When TI-RADS was diagnosed as grade 5,the rate of pathological diagnosis of malignant nodules was as high as 95.65%.The specificity,sensitivity,accuracy,negative predictive value and positive predictive value of TI-RADS grading for benign and malignant tumors were 77.10%,92.42%,82.23%,95.28%and 67.03%,respectively.Taking the diagnosis conclusion of pathological examination of thyroid nodules as the gold standard for diagnosis,the ROC working curve of TI-RADS grade for thyroid nodules was drawn.The area under the curve was 0.939,and the standard error was 0.020.P<0.01,95%confidence interval was 0.899 and 0.978.There were significant differences between benign and malignant thyroid nodules in structure,ratio of longitudinal diameter to transverse diameter,shape,boundary,edge,hyperechoic lesion and internal echo(P<0.05).Binary Logistic regression analysis of the above-mentioned independent variables showed that solid,solid components,micro-calcification,low echo,small lobulation or burr on the margin of nodule,and the aspect ratio? 1,the malignant degree was higher.Conclusion:Kwak TI-RADS system has high accuracy,sensitivity,negative predictive value and less high positive predictive value,specificity of the diagnosis of benign and malignant thyroid nodules.As a simple,casy-to-master and practical evaluation method,it is more comprehensive in evaluating the characteristics of thyroid nodules and reduces the subjective factors among observers,which indirectly improves the objectivity and accuracy of diagnosis.It provides a great help for clinical diagnosis and treatment,and has high use value.Ultrasound features were solid,solid components were dominant,marginal lobulation and burr,low echo,microcalcification,aspect ratio ?1,there is statistical significance in differentiating benign and malignant thyroid nodules,suggesting that malignancy is possible,and that the more signs arc,the greater the possibility of malignancy.However,with the development of thyroid nodule research in recent years,as a relatively concise means of analysis,some characteristic sonographic manifestations of thyroid nodules are inevitably ignored.The white paper published by ACR is standardized in terms of description words.TI-RADS,as a non-invasive analysis system of ultrasound,has a high accuracy,and sensitivity.When the ultrasonic examination of nodules is not qualitative,FNA or other related examinations can be carried out to avoid unnecessary surgical procedures,alleviate the pain of patients,and be conducive to the rational allocation of medical resources.