The combination of ultrasound patterns and superb microvascular imaging of ATA(2015) guidelines in the differentiation of benign and malignant thyroid nodules / 中华内分泌代谢杂志

ABSTRACT

The study included 197 thyroid nodules which were confirmed by fine-needle aspiration cytology or histopathologic examination. All nodules were graded with malignancy risk stratification of thyroids nodule accordingto the 2015 American Thyroid Association(ATA)management guidelines. Both color Doppler flow imaging (CDFI) and superb microvascular imaging(SMI) were used to classify blood flows of thyroid nodules according to Adler's grading criteria. Morphologic and distribution features of blood flow were also observed by monochrome (mSMI). The optimal threshold drawing from ROC curve and diagnostic efficacy of single and combinative modality were calculated. The results showed that mSMI was more sensitive to detect blood flow of thyroid nodules than other Doppler techniques(P<0.01). Microvascular morphologic features between benign and malignant thyroid nodules were significantly different(P<0.01). The area under ROC curves of ATA,mSMI,and ATA+mSMI were 0.745, 0.740,and 0.834,respectively,suggesting that the diagnostic performance of ATA+mSMI is superior to that of ATA or mSMI alone. There was no significant deference in the sensitivity among ATA, mSMI, and ATA+mSMI (P>0.05). But the specficity and accuracy of combinative modality ATA+mSMI was significantly higher than that of ATA or mSMI alone(P<0.05).