Combination of Thyroid Imaging-reporting and Data System and Ultrasound Elastography in the Differentiation of Benign and Malignant Thyroid Nodules / 中国医学影像学杂志

ABSTRACT

PurposeTo evaluate the value of combined employment of thyroid imaging-reporting and data system (TI-RADS) and ultrasound elastography (UE) in the differentiation of benign and malignant thyroid nodules.Materials and Methods The clinical data of 174 patients with 232 thyroid nodules confirmed surgically or pathologically with puncture biopsy were retrospectively analyzed. All nodules were examined by ultrasound and UE. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of TI-RADS, UE and the combination of the two methods were calculated respectively, and the receiver operating characteristic curve (ROC) was drawn to evaluate the value of each of the three methods in differentiating benign and malignant thyroid nodules by comparison of area under curve (AUC).Results The diagnostic sensitivity, specificity and accuracy of UE (number of benign nodules 155, number of malignant nodules 77) were 88.9%, 91.8% and 90.9%, respectively; those of TI-RADS (number of benign nodules 153, number of malignant nodules 79) were 76.4%, 85.0% and 82.3%, respectively. The values measured by UE were significantly higher than those by TI-RADS (χ2=3.920 and 7.446,P<0.05). The sensitivity, specificity and accuracy measured by the combined use of the two methods (number of benign nodules 155, number of malignant nodules 77) were 93.0%, 93.7% and 93.5%, respectively, which were higher than either of the methods, and the difference was statistically significant (χ2=7.725, 6.450 and 13.728,P<0.05). The areas under the curve (AUC) were 0.833 and 0.812 respectively for UE and TI-RADS; the AUC for the combination of the two methods was 0.914, which had significantly higher diagnosis accuracy than that by any single method, and the difference was statistically significant (Z=1.95 and 2.55,P<0.05). Conclusion Compared with gray scale ultrasound, the combination of TI-RADS and UE has higher diagnostic sensitivity and accuracy for excluding malignancy in diagnose of thyroid nodules.