Diagnostic Value Of The Thyroid Imaging Reporting And Data System Proposed By The American College Of Radiology For Hashimoto's Thyroiditis With Thyroid Nodules

ObjectiveThe purpose of this article is to explore the diagnostic value of the Thyroid Imaging Reporting and Data System proposed by the American College of Radiology in 2017 for the diagnosis of Hashimoto's thyroiditis with thyroid nodules.MethodsA total of 132 nodules were selected from 86 Hashimoto's thyroiditis patients admitted to the Department of Thyroid Surgery of the Fifth Affiliated Hospital of Zhengzhou University from June 2017 to September 2019.Retrospective analysis of the ultrasound image data and pathological results.Refer to the 2017 ACR TI-RADS classification to score and classify all nodules,and use pathological results as the gold standard to establish the receiver operating characteristic curve(ROC curve),and calculate the sensitivity,specificity,negative predictive value,positive predictive value and Youden index to obtain the best diagnostic cut-off value and evaluate the diagnostic efficacy of ACR TI-RADS classification.Results1.Of all the nodules,47 were diagnosed as malignant and 85 were diagnosed as benign.Among the general clinical and nodular characteristics of the study population,regarding the statistics of benign and malignant patients,there was no significant statistical difference in the sex,age,nodule size and different location,but there were differences between single and multiple nodules(P<0.05).Single nodules have higher malignancy risk than multiple nodules.2.ACR TI-RADS classification is compared with pathological results.The negative predictive values of TR-1 and 2 are 100.00%.The positive predictive values of TR-3 to 5 are 3.85%,16.00%and 71.70%,respectively.The positive predictive value of classes 3 to 5 showed an upward trend.3.The area under the receiver operating characteristic curve(AUC)was 0.882 and the 95%confidence interval was 0.821-0.943(P<0.05).According to the ROC curve,the best diagnostic cut-off value is 5 points.When the total nodule score>5 points is used as the criterion for the diagnosis of malignant nodules,the specificity is 72.94%,the sensitivity is 85.11%,and the Youden index is 0.58.4.When TR-1 to 3 were negative and TR-4 to 5 were positive,the sensitivity,specificity,negative predictive value,positive predictive value were 97.87%?32.94%?96.55%and44.66%,respectively.When TR-1 to 4 were negative and TR-5 was positive,the sensitivity,specificity,negative predictive value,positive predictive value were 80.85%?58.82%?84.75%and71.70%,respectively.TR-4 nodules were removed.When TR-1 to 3 were negative and TR-5 was positive,the sensitivity,specificity,negative predictive value,positive predictive value were 97.44%?65.12%?96.55%and71.70%,respectively.ConclusionsThe ACR TI-RADS classification has certain diagnostic value for the judgment of benign and malignant thyroid nodules in the context of Hashimoto's thyroiditis.When the total nodule score>5 points is used as the criterion for the diagnosis of malignant nodules,its efficacy is the highest.At the same time,ACR TI-RADS classification has the advantages of wide coverage,simple classification method,easy to master,and easy to popularize and apply.