| Objective: This study aims to examine the correlation between the hardness of solid nodules in the thyroid gland and the likelihood of malignancy.Additionally,the study seeks to evaluate the effectiveness of routine ultrasonography,ultrasound elastography(UE),and puncture hardness measurement in distinguishing between benign and malignant thyroid nodules.Methods: This study collected data from 61 patients who underwent surgical treatment for single or multiple thyroid nodules at our hospital between May 2022 and November 2022.A total of 93 diseased tissues were included in the analysis.Prior to surgery,all patients underwent ultrasound examination to determine the size,number,and internal echo of thyroid lesions.UE was performed to preliminary evaluate the hardness of the lesions.During the operation,isolated thyroid lesions were puncture-hardness measured using precision pressure sensing equipment.Based on pathological diagnosis,the lesion tissues were categorized into benign and malignant groups.The study analyzed the correlation between ultrasonic grading,elasticity score,and puncture hardness of patients with benign and malignant nodules.The results were used to draw a Receiver Operating Characteristic(ROC)curve.To assess the diagnostic efficacy of each test alone and combined,we calculated sensitivity,specificity,positive predictive value,negative predictive value,accuracy,and the area under the ROC curve(AUC).Results: Based on the pathological results,47 out of the 93 diseased tissues were found to be benign while the remaining 46 were identified as malignant.1.The routine ultrasound had an AUC of 0.805 and showed a sensitivity of91.3%,specificity of 70.2%,accuracy of 75.0%,positive predictive value of 89.2%,and negative predictive value of 80.7%.ACR TI-RADS 4A was determined to be the optimal cut-off value.2.The UE score had an AUC of 0.811 and showed a sensitivity of 76.1%,specificity of 80.6%,accuracy of 79.5%,positive predictive value of 77.6%,and negative predictive value of 78.5%.Elasticity score 4 was determined to be the optimal cut-off value.The detection rate of high score UE in malignant lesions was higher than that in control group.The results were statistically significant(P < 0.05).3.The puncture hardness measurement had an AUC of 0.856 and showed a sensitivity of 87.0%,specificity of 83.0%,accuracy of 83.3%,positive predictive value of 86.7%,and negative predictive value of 84.9%.The results indicated that puncture hardness values of most thyroid malignancies were greater than those of benign lesions.The results were statistically significant(P < 0.05).Spearman correlation analysis suggested that there was a positive correlation between hardness measurement and elasticity score of thyroid lesions(P < 0.05).4.The combined diagnosis had an AUC of 0.874 and showed a sensitivity of95.7%,specificity of 76.6%,accuracy of 80.0%,positive predictive value of 94.7%,and negative predictive value of 85.7%.The combined diagnosis significantly improved the diagnostic value of benign and malignant thyroid solid nodules compared with single examination.Conclusion: 1.Thyroid nodule hardness is a crucial indicator in detecting early signs of thyroid malignant tumors.Nodules with higher hardness are more likely to be malignant,making it necessary to routinely monitor the thyroid hardness information.This monitoring will aid in preoperative screening of malignant nodules,ultimately leading to better patient outcomes.2.Conventional ultrasound,UE,and puncture hardness measurement have a significant diagnostic role in distinguishing between benign and malignant thyroid solid nodules.When used in combination,these three methods have the best diagnostic efficacy and can provide valuable information for individualized precision treatment. |
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