Combination of TI-RADS and Ultrasonic Elastography in Differentiation of Thyroid Nodules

Objective To investigate the value of combination of TI-RADS and ultrasonic elastography(UE) in the differentiation of thyroid nodules.Methods 125 patients with 190 nodules(133 benign,57 malignant) in the study were divided into two groups according to whether the diameter of nodules were larger than 10 mm or not.The nodules were examined by ultrasound and UE.The nodules were graded by TI-RADS and proved by pathologic findings.Receiver operating characteristic curve(ROC) was established by taking pathologic findings as golden standard to compare the value of TI-RADS and UE in differentiation of thyroid nodules.Results The sensitivity,specificity and accuracy of UE were 88%,92%,and 91% respectively,significantly higher than those of TI-RADS,which were 72%,84%,and 81%(P0.05).The combination of the two methods could bring higher sensitivity,specificity and accuracy than single method.The areas under the curve(AUC) were 0.926 and 0.869 respectively for UE and TI-RADS,and the difference was statistically significant(P0.01).The AUC for the combination of the two methods was 0.973,with significantly higher diagnosis accuracy than single method(P0.01).In the nodule diameters ≤ 10 mm group,diagnostic accuracy of UE was significantly higher than TI-RADS(P0.05),while in the nodule diameters 10 mm group,diagnostic accuracy of TI-RADS was significantly higher than UE(P0.05).Conclusion Diagnostic value of UE was better than TI-RADS.The two methods can mutually complement each other in diagnosing thyroid nodules with different diameters.The combination of TI-RADS and UE could improve the differentiation of thyroid nodules.