Characteristics Of High Frequency Ultrasound And Color Doppler Flow Imaging In Thyroid Nodules

Objective:To investigate the characteristics of high frequency ultrasound for the patients with thyroid nodules,and use proposed TI-RADS(Thyroid Imaging Reporting And Data System)to classify all the thyroid nodules.Combined TI-RADS classification and the features of color Doppler ultrasound and Doppler blood flow parameters for each nodule,we tried to diagnose thyroid nodules between benign and malignant nodules,so as to provide clinical physicians a more appropriate method and decision-making strategy for patients with of thyroid nodules by ultrasound findings.Methods:The study involves 90 patients collected in our hospital from April 2014 to April 2017,compromised of 50 cases of benign thyroid nodules and 40 cases of malignant thyroid nodules respectively.For patients with multiple nodules,the most meaningful and representative nodules,based upon final pathology results,were selected as our study subjects.All the patients underwent high frequency ultrasound and color Doppler ultrasound examination before surgical operation and all the patients were informed and signed the consent form.For all the patients the characteristics of high frequency ultrasound and several parameters of color Doppler ultrasound were recorded and compared with pathology results and used for diagnostic value calculation and statistical analysis.With the two-dimensional ultrasound imaging,we mainly observed the number,the boundary,the morphology,the capsule,the internal echo pattern,the calcification pattern of nodules and the cervical lymph nodes etc.And we adapted a new TI-RADS scoring system to evaluate every nodule and give it a certain score.With the color Doppler ultrasound,the color Doppler flow imaging technique was used to assess the internal and peripheral flow pattern of the masses,and a semi-quantitative evaluation method was used to give a certain score for every nodule.The pulse Doppler technique was used to measure the peak systolic velocity(PSV)and resistance index(RI)of the blood flow within the nodule or closely around.The final pathology results were collected and compared with all the ultrasound findings.The diagnostic coincidence rates for benign and malignant thyroid nodules were statistically compared by single two-dimensional ultrasound or by single color Doppler flow imaging or by combined technique of both.Results:There were significant differences in TI-RADS classification between the benign thyroid nodules and the malignant thyroid nodules(p<0.05).Most benign thyroid nodules were classified into TI-RADS 1,2,3 categories and most malignant thyroid nodules were classified into TI-RADS 4 and 5 categories.There are statistically differences(p<0.05)between the benign and malignant groups in the high frequency ultrasound features such as halo,low internal echo,boundary irregularity,lymph node metastasis and micro calcification.Also there are statistically differences(p<0.05)between the two groups in the color Doppler parameters such as semi-quantity blood flow distribution,peak systolic velocity(PSV)and resistance index(RI).However,there were some overlapping of the blood flow distribution level between the benign thyroid nodules and the malignant thyroid nodules.The diagnosis coincidence rates were 93.33%with based upon high frequency ultrasound and 88.89%with blood flow parameters(PSV,RI)based on color Doppler ultrasound.The diagnosis coincidence rate would be 98.89%if combined TI-RADS classification with blood flow parameters(PSV,RI),obviously higher than any single diagnosis method(p<0.05).Conclusion:There were significant differences in TI-RADS classification between the benign thyroid nodules and the malignant thyroid nodules(p<0.05).Most benign thyroid nodules were classified into TI-RADS 1,2,3 categories and most malignant thyroid nodules were classified into TI-RADS 4 and 5 categories.According to the differences,we can provide reliable diagnostic basis for the differential diagnosis between benign and malignant thyroid nodules,and give directional guideline for further clinical diagnosis and treatment of thyroid nodules.The diagnostic rates of benign and malignant thyroid diseases can be further promoted if the TI-RADS classification method by high frequency ultrasound characteristics and blood flow parameters(PSV,RI)by color Doppler be effectively combined and integrated for diagnosing and evaluating all the patients with thyroid nodules.The application of TI-RADS classification method by high frequency ultrasound characteristics and blood flow parameters(PSV,RI)by color Doppler for patients with thyroid nodules is worth of clinical attention and further investigation.