To Explore The Value Of TI-RADS Standard Grade 4 Combined With Contrast-enhanced Ultrasonography And TSH In The Diagnosis Of Benign And Malignant Thyroid Nodules And The Choice Of Treatment

Objective: To explore the value of TI-RADS standard grade 4 combined with contrast-enhanced ultrasonography and TSH in the diagnosis of benign and malignant thyroid nodules and the choice of treatment.Methods : 30 patients with thyroid nodule were selected in Baotou School of clinical medicine,Inner Mongolia Medical University from December 2018 to December 2019.All the selected nodules were examined by two-dimensional ultrasound and TI-RADS standard grade 4according to the malignant characteristics of ultrasound nodule.Patients with TI-RADS standard grade 4 were examined by contrast-enhanced ultrasound and TSH was measured.All the nodules had postoperative pathology,and the results of postoperative pathology were as follows Go Id stander for diagnosis: To evaluate the accuracy of TI-RADS standard grade 4,CEUS qualitative and quantitative indexes,TI-RADS standard grade 4 combined with CEUS qualitative and quantitative indexes,and TSH in judging the benign and malignant nature of thyroid nodules,so as to select the most effective method for diagnosis,improve the accuracy of preoperative diagnosis of thyroid nodules,and reduce unnecessary operations.The chi-square test was used for the enumeration data,and the independent sample t test was used for the comparison between measurement data sets.The sensitivity,specificity and accuracy of TI-RADS standard grade 4,contrast-enhanced ultrasonography and their combination in diagnosing benign and malignant thyroid nodules were calculated respectively.Chi square test was used for the difference of diagnostic accuracy of each method,and the optimal boundary value was determined by ROC analysis curve coordinates,(P <0.05).The difference was statistically significant.Results:1.The average age of patientswith thyroid malignant nodule is lower than that of patients with benign nodule.2.The accuracy rate of TI-RADS grade 4 diagnosis of thyroid malignancy was 34.00%,(P <0.05).3.The diagnostic efficiency of qualitative(non-contrast software analysis)low enhancement,late peak time and quantitative(contrast software analysis)peak intensity(? peak)and peak time(? TP)is higher than that of patients with benign nodule.Theaccuracy of non-contrast software analysis is 74.00%;72.00%,respectively.The accuracy rate was 88.00%,90.00%(P < 0.05).4.This study showed TI-RADS standard grade 4 combined with qualitative and quantitative indexes of contrast-enhanced ultrasound.The accuracy rate of benign and malignant thyroid nodule diagnosis after re grading was 6.67%,6.67%,75.00% in non-contrast software analysis group,and 3.33%,55.56%,and 100% in contrast software analysis group.When both qualitative and quantitative indexes of contrast-enhanced ultrasound were met,the accuracy rate was significantly higher than that of non-contrast TI-RADS standard grade 4,(P < 0.05).Conclusion:1.In clinic,TI-RADS standard grade 4 can be used to judge the benign and malignant quality of thyroid nodules.2.The qualitative indexes of contrast-enhanced ultrasound,the time of late peak and the quantitative indexes of contrast-enhanced ultrasound ? peak and ? TP are of certain value to judge the benign and malignantproperties of thyroid nodules,and the accuracy of software analysis is significantly higher than that of non-software analysis.3.When TI-RADS standard grade 4 meets both qualitative and quantitative indexes of contrast-enhanced ultrasound,its diagnostic ability is significantly higher than that of non-contrast-enhanced TI-RADS standard grade 4.