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Objective To evaluate the value of superb micro-vascular imaging(SMI) in the detection of TI-RADS 4 thyroid nodules . Methods A retrospective analysis of 61 patients( 68 thyroid nodules) with grade 4 TI-RADS diagnosed by routine ultrasound and undergone SMI were performed ,and the differences between CDFI and SMI were compared . The TI-RADS level were corrected by CDFI and SMI technology , combined with the pathological results to compare the diagnostic efficacy before and after the correction . At the same time ,the related factors had been collected to evaluate the risk factors and to compare the value of SMI in benign and malignant nodules . Results SMI was more likely to detect the type Ⅲ blood flow ( P =0 .001) of malignant nodules . The area under the ROC curve before TI-RADS correction ,after CDFI correction and SMI correction were 0 .66 ,0 .69 and 0 .78 ,respectively . Compared with before TI-RADS correction and after CDFI correction ,the area under the curve of SMI correction was significant different ( P=0 .002 ,0 .009) . There was no significant difference in the area under the curve between after CDFI correction and before correction ( P = 0 .4196 ) . The sensitivity of SMI was higher ,but there was no significant difference ( P >0 .05) . After single factor analysis and multivariate analysis ,central blood flow and perforating blood flow found by SMI were not independent risk factors for thyroid cancer . Conclusions SMI is more effective than CDFI in detecting TI-RADS 4 thyroid nodules ,and it is expected to be an auxiliary tool for the diagnosis of benign and malignant thyroid nodules .
ABSTRACT
Objective To explore the diagnostic value of ultrasound guided fine needle aspiration biopsy (US-FNAB) for thyroid imaging reported and data system (TI-RADS) 4 class ≤ 10 mm thyroid nodules.Methods The preoperative ultrasound features of patients with thyroid nodule who received USFNAB examination were retrospectively analyzed,the malignant risk of each nodule was evaluated and classified according to TI-RADS.TI-RADS 4a class thyroid nodules and diameter ≤ 10 mm of 365 patients were classified as suspicious nodules and received US-FNAB examination.The nodules were classified as ＜5 mm and 5-10 mm groups.The results of cytologic diagnosis were compared with the pathological diagnosis,and the differences for nodules with different size were analyzed.Results Among 365 TI-RADS 4 class thyroid nodules diagnosed by the cytology,68 nodules were malignant;81 nodules were suspicious of malignancy;193 nodules were benign;6 nodules were unsatisfactory;and 17 nodules were undetermined.According to postoperative pathology or follow-ups,153 nodules were malignant and 212 nodules were benign.The difference between US-FNAB results and pathology was not significant (P ＞ 0.05).Cytologic positive rate and actually malignant rate of the nodules in 5-10 mm group were higher than ＜ 5 mm groups (P ＜ 0.05).The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of US-FNAB cytological diagnosis of TI-RADS 4 class thyroid nodule were 92.2％,96.2％,94.6％,94.4％and 94.5％,respectively.Conclusion US-FNAB examination is valuable for the diagnosis of TI-RADS 4a class thyroid nodules and improves the preoperative diagnosis.
ABSTRACT
Objective To explore the application value of ultrasound-guided fine needle aspiration biopsy(FNAB) in diagnosing thyroid nodules of TI-RADS 4-6 categories.Methods A retrospective analysis was made on the pathologic data of 494 patients (totally 501 nodules) who underwent TI-RADS ultrasonographic stratification and ultrasound-guided FNAB.168 thyroid nodules of TI-RADS 4-6 categories were selected from 163 patients and classified into three groups:group T,TI-RADS 4A categories;group Ⅱ,TI-RADS 4B category; group Ⅲ,TI-RADS 5-6 category(the pathologically confirmed cases in category 6 had been removed).The ultimate pathologic findings were taken as golden standards to calculate the accuracy,sensitivity,specificity,positive predictive value of ultrasound-guided FNAB in the three groups.ROC curve was drawn to evaluate the diagnostic value of FNAB.Results The accuracy,sensitivity,specificity,positive predictive value of the ultrasound-guided FNAB in the three groups were listed as follows:group Ⅰ 74.4％,73.3％,75.0％,64.7％;group Ⅱ 83.9％,87.5％,71.4％,91.3％;group Ⅲ 89.3％,91.7 ％,75.0％,95.7 ％ respectively.The positive predictive values of the ultrasound-guided FNAB for group Ⅰ and group Ⅱ was higher than that of conventional TI-RADS classification criteria,so the difference was statistically significant; while the positive predictive values for group Ⅲ was close to the conventional ultrasound TI-RADS classification criteria,the difference was not statistically significant.Conclusions The combination application of TI-RADS classification criteria and FNAB can improve the accuracy of ultrasound diagnosis in group Ⅰ and group Ⅱ,and reduce the puncture rate of group Ⅲ.