Diagnostic Value Of TI-RADS And Its Correlation With Clinicopathological Results

Background: In recent years,with the improvement of people's living standard,the detection rate of thyroid nodules has been increasing year by year.Therefore,it is urgent to identify benign and malignant thyroid nodules accurately with preoperative tests.There is some room for further improvement of the accuracy of high-frequency thyroid ultrasonography currently used.At the same time,lacking of laboratory test method which could accurately distinguish malignant thyroid nodules from benign ones is still in clinical practice.The purpose of this study was to explore the way of combining imaging examination method with laboratory test method to improve the accuracy of preoperative diagnosis of thyroid nodules.Objective: 1.To verify the correlation between the ultrasonic images of the Thyroid Imaging Reporting and Data System(TI-RADS)of the American College of Radiology(ACR)from different risk stratification and the clinicopathologic results.2.To verify whether the imaging examination method combined with laboratory test method can improve the accuracy of preoperative diagnosis of thyroid nodules or not.Investigating the diagnostic value of TI-RADS and its correlation with clinicopathologic results.Methods:A total of 200 patients with thyroid surgery in the department of oncology,the First Hospital of Lanzhou University from January 2018 to December 2019 were selected.Risk stratification of thyroid nodules was performed according to the TI-RADS introducing by ACR in 2017.Analyzing the correlation between each risk stratification of thyroid nodules and their clinicopathologic results and evaluating the diagnostic value of TI-RADS combining with laboratory tests comprehensively.Results: A total of 200 cases were included in this study,including 141 benign cases and 59 malignant cases.The results of difference analysis shows that the malignant ratio of nodules with solid,hypoechoic,very hypoechoic,taller-than-wide or punctate echogenic foci from different composition,echogenicity,shap,margin or echogenic foci is higher than others'(p<0.001).Patients with positive cervical and supraclavicular lymph nodes present a higher malignant ratio comparing to their counterpart with a negative ones(p=0.005).Comparing the diagnostic efficiency of TI-RADS,serum thyroid stimulating hormone(TSH): thyroglobulin(Tg)level test and TI-RADS combining with serum TSH:Tg level test,the area under curve(AUC)are 0.834(95%CI 0.775?0.883;p<0.001),0.74(95%CI 0.673?0.799;p<0.001)and 0.843(95%CI 0.785?0.891;p<0.001)and accuracy are 78.5%,70.5% and 83.5% respectively,indicating that using TI-RADS combining with serum TSH:Tg level test,with the best diagnostic efficiency,could distinguish benign and malignant thyroid nodules effectively.Conclusion: 1.The ultrasonic images of thyroid nodules from different risk stratification do have positive correlation with their clinicopathologic results.2.Using TI-RADS combining with serum TSH:Tg level test can improve the accuracy of postoperative diagnosis in thyroid nodules.