Comparison Of Clinical Efficacy Between 2017 ACRTI-RADS And Modified KwakTI-RADS In The Diagnosis Of Benign And Malignant Thyroid Nodules

Objective: To compare the clinical efficacy of the American College of Radiology Thyroid Imaging Report and Data System(ACR TI-RADS)and the modified Kwak TI-RADS in the diagnosis of benign and malignant thyroid nodules.Methods: The preoperative ultrasound images and postoperative pathologic results were selected for 793 patients.The modified Kwak TI-RADS classification was based on the five malignant sonographic signs of Kwak TI-RADS plus capsule invasion and cervical lymph node metastasis.All cases were classified according to 2017 ACR TI-RADS and modified Kwak TI-RADS classification criteria.The specificity,sensitivity,positive predictive value,negative predictive value and accuracy of the two classification methods were calculated respectively,and the receiver operating characteristic curve(ROC curve)was drawn to compare the diagnostic value of the two different classification criteria for benign and malignant thyroid nodules.Their clinical efficacy was compared.Result: The sensitivity,specificity,positive predictive value,negative predictive value,accuracy and area under ROC curve(AUC)of ACR TI-RADS were 80.09%,91.26%,77.97%,92.23%,88.14% and 0.904 respectively.The sensitivity,specificity,positive predictive value,negative predictive value,accuracy and area under the curve(AUC)of modified Kwak TI-RADS were 81.90%,95.45%,87.44%,93.17%,91.68% and 0.922 respectively.The positive predictive value,accuracy and AUC of the two different classification criteria were significantly different(P < 0.05),while the negative predictive value,sensitivity and specificity were not significantly different(P > 0.05).Conclusion: Both of the two kinds of TI-RADS have higher diagno-stic value,and the modified Kwak TI-RADS has better accuracy and positive predictive value,and has higher clinical diagnostic efficacy.