Comparison of the value of three different methods for diagnosing TBSRTC Ⅲ-Ⅴ thyroid nodules individually and in combination
Objective To investigate the value of the American College of Radiology Thyroid Imaging,Reporting and Data System(ACR TI-RADS),real-time ultrasound elastography(RTE),and contrast-enhanced ultrasound(CEUS),individually and in combination,in the diagnosis of TBSRTC Ⅲ-Ⅴ thyroid nodules.Methods A retrospective analysis was performed on 106 patients with TBSRTC Ⅲ-Ⅴ thyroid nodules who were pathologically diagnosed by fine needle aspiration cytology at Bao Ji People's Hospital between February 2022 and December 2023.All patients were assessed using ACR TI-RADS grading,RTE,and CEUS,with postoperative pathological diagnosis serving as the gold standard.The diagnostic effectiveness of ACR TI-RADS,RTE,and CEUS,individually and in combination,for TBSRTC Ⅲ-Ⅴ thyroid nodules was analyzed using the receiver operating characteristic(ROC)curve.Results There were statistically significant differences in nodule size,blood supply,and proportion of TBSRTC Ⅲ-Ⅴ nodule between the two groups(x2=4.67,42.56,26.09,all P＜0.05),while there was no statistical significance in other general data(all P＞0.05).Of the 106 patients with TBSRTC Ⅲ～Ⅴ nodules,69 patients were diagnosed with malignant nodules and 37 with benign nodules.The area under the curve(95％CI)of ACR-TIRADS,RTE,and CEUS in identifying malignant nodules were 0.860[95％CI(0.779-0.920)],0.712[95％CI(0.616-0.796)],and 0.788[95％CI(0.698-0.862)],respectively,with sensitivities of 85.51％,66.67％,and 73.91％,respectively and specificities of 86.49％,75.68％,and 83.78％,respectively.The Youden indices were 0.719,0.423,and 0.577,respectively.Among the three diagnostic methods,ACR TI-RADS had the highest diagnostic efficiency,while RTE had the lowest.Pairwise comparisons in ROC analysis revealed statistically significant differences between ACR TI-RADS and RTE,ACR TI-RADS and CEUS,as well as RTE and CEUS(Z=4.22,3.02,2.78,all P＜0.05).The ACR TI-RADS+RTE+CEUS combination had the highest sensitivity,specificity,Youden index,and AUC(95％CI)values:94.20％,89.19％,0.834,and 0.917(95％CI:0.847-0.962).The RTE+CEUS combination had the lowest values:76.81％,78.38％,0.552,and 0.776(95％CI:0.685-0.851).The pairwise comparison results in the ROC curve revealed that significant differences were observed between ACR TI-RADS+RTE and RTE+CEUS,ACR TI-RADS+RTE and ACR TI-RADS+RTE+CEUS,ACR TI-RADS+CEUS and ACR TI-RADS+RTE+CEUS,RTE+CEUS and ACR TI-RADS+RTE+CEUS,and ACR TI-RADS+CEUS and RTE+CEUS(Z=3.13,2.40,2.16,4.07,3.32,all P＜0.05).However,there was no significant difference between ACR TI-RADS+RTE and ACR TI-RADS+CEUS in ROC analysis(Z=0.06,P＞0.05).Conclusion The combined utilization of ACR TI-RADS,RTE,and CEUS offers enhanced information on thyroid nodules,encompassing malignant risk stratification,nodular elasticity,and contrast agent perfusion,thereby aiding in improving the diagnostic precision of TBSRTC Ⅲ-Ⅴ malignant nodules.
Thyroid noduleCarcinomaUltrasonographyElasticity imaging techniquesEndoscopic ultrasound-guided fine needle aspirationBiopsy,needlePhlebographyDiagnosis
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