Value of thyroid imaging-reporting and data system combined with shear wave elastography and superb microvascular imaging in the differentiation of benign and malignant thyroid nodules

Abstract

Objective To investigate the value of thyroid imaging-reporting and data system (TI-RADS) combined with shear wave elastography (SWE) and superb microvascular imaging (SMI) in the differentiation of benign and malignant thyroid nodules. Methods A total of 104 patients with thyroid nodules admitted to Jinzhong Hospital of Traditional Chinese Medicine from January 2015 to July 2017 were selected. All the nodules underwent SWE, SMI and TI-RADS grading. The quantitative score was gotten by the TI-RADS system and the results were confirmed by the pathology examination. According to the readjusted TI-RADS system and pathologic results, the receiver operating characteristic curve (ROC) was drawn to evaluate the sensitivity and specificity of benign and malignant thyroid nodules by the area under curve (AUC). Results There were 157 pathologically proven thyroid nodules (104 patients) including 107 benign lesions and 50 malignant lesions. When the AUC was 0.930 (95%CI: 0.896-0.964), the sensitivity and specificity of TI-RADS were 89.61% and 93.10%, respectively. The SWE Young’s modulus value of benign nodules was (23.15±10.69)kPa, which was significantly higher than (59.75±21.19)kPa of malignant nodules (t=15.951, P<0.001). When the AUC was 0.930 (95%CI: 0.889-0.973), the value of 40.10 kPa was considered as the critical value for diagnosis, and the sensitivity and specificity of SWE were 86.09% and 83.91% respectively. When the AUC was 0.876 (95%CI: 0.865-0.857), the sensitivity and specificity of SMI were the highest (82.49%, 94.41%), which were higher than those of the SME (χ2=7.437, P<0.001). When the AUC was 0.960 (95%CI: 0.940-0.980), the sensitivity and specificity of the comined grading diagnosis were the highest (95.00%, 94.19%), which were higher than those of the TI-RADS (χ2=13.613, P<0.001). Conclusions Combined examination of TI-RADS, SWE and SMI can significantly improve the sensitivity and specificity of diagnosis of benign and malignant thyroid nodules and it is worthy of clinical promotion. Key words: Thyroid imaging-reporting and data system; Shear wave elastography; Superb microvascular imaging; Benign and malignant thyroid nodules; Differential diagnosis