ABSTRACT
Objective: To explore the value of superb micro-vascular imaging (SMI) combined with the 2017 American Radiological Society thyroid imaging reporting and data system (TI-RADS) in differential diagnosis of benign and malignant thyroid nodules. Methods: A total of 187 thyroid nodules in 179 patients were classified into TR types 1 to 5 according to TI-RADS with conventional ultrasound, and then TI-RADS classification was re-adjusted in combination with SMI technology. The optimal diagnostic boundary was determined by ROC curve, and the diagnostic efficacy of the two methods was compared. Results: Before correction, the actual malignant rates of TR 1 to 5 was 0, 0, 5.00%, 37.74% and 64.29%. After correction with SMI technology, the actual malignant rates of TR 1 to 5 was 0, 0, 5.56%, 23.26% and 66.36%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy before and after correction with SMI technology was 75.00%, 66.02%, 64.29%, 76.40%, 70.05% and 86.91%, 64.08%, 66.36%, 85.71%, 74.33%, respectively. AUC and sensitivity after correction were both higher than before (Z=-2.616, -1.988; P=0.009, 0.047). Conclusion: SMI technology can show perforating blood flow in thyroid nodules, which combined with TI-RADS can improve the diagnostic efficacy of thyroid nodules.