Diagnose Value Of Contrast-enhanced Ultrasound In Combination With Thyroid Imaging Reproting And Data System(TIRADS)

Objective: To explore the value of contrast-enhanced ultrasonography in the evaluation of benign and malignant thyroid nodules,and whether TIRADS classification after contrast agent clearance(post-TIRADS)、 contrast-enhanced ultrasonography(CEUS)combined with TIRADS can improve the diagnostic efficiency of benign and malignant thyroid nodules.Methods:To collect the data of patients who underwent thyroid ultrasonography in our hospital from December 2017 to May 2019:1.The differences in the two-dimensional ultrasonographic features of 154 cases of thyroid nodules before and after the whole process of contrast-enhanced ultrasound were analyzed and compared.according to the characteristics of two-dimensional ultrasound images,each nodule was evaluated by TIRADS classification before angiography(TIRADS)and TIRADS classification after angiography(post-TIRADS).To compare the diagnostic efficacy of TIRADS and post-TIRADS in improving the diagnosis of thyroid grading.2.The characteristics of two-dimensional ultrasonography and contrast of thyroid nodules in 184 cases were analyzed and recorded.TIRADS classification of each nodule was performed according to the characteristics of two-dimensional ultrasonography.The contrast-enhanced ultrasonographic features of benign and malignant nodules were analyzed.To compare the diagnostic efficacy of TIRADS alone and in conbination with contrast-enhanced ultrasonography,and to explore the role of contrast-enhanced ultrasonography in the diagnosis of thyroid nodules.Results:1.The ultrasonographic characteristics of echogenicity,margins and calcification of benign nodules were not statistically significant before and after angiography(P = 0.905,0.069,0.135,respectively).The ultrasonographic features of calcification and margins of malignant nodules were different before and after angiography(P = 0.000,P = 0.041),but there was no significant difference in echo characteristics before and after angiography(P > 0.145).Compared to TIRADS before angiography,the sensitivity of post-TIRADS classification was improved(P <0.001).The diagnostic accuracy of post-TIRADS was improved(P > 0.05),and the specificity was decreased(P > 0.05).2.The contrast-enhanced ultrasonographic features such as enhancement intensity,homogeneity,ring enhancement and the margins of nodules during enhancement were significantly different in benign and malignant nodules(P < 0.05).The area under the curve of TIRADS was 0.671(95%CI was 0.598-0.738,P = 0.000),and the area under the curve of contrast-enhanced ultrasonography was 0.770(95%CI was 0.703-0.829,P = 0.000).The area under the curve of contrast-enhanced ultrasonograph combined with TIRADS classification was 0.761(95%CI 0.693-0.821,P = 0.000).The difference of area under the three curves was statistically significant.Conclusions:1.After angiography,the two-dimensional ultrasonographic features of thyroid nodules such as margins and calcification were displayed more clearly.Compared with TIRADS,the sensitivity were improved in Post-TIRADS.2.CEUS has a certain value in the evaluation of benign and malignant thyroid nodules.Inhomogeneous low enhancement and irregular margins during enhancement are associated with malignant thyroid nodules.Ring enhancement is associated with benign thyroid nodules.The specificity of CEUS combined with TIRAD could be significantly improved.