Value of biopsy by contrast-enhanced ultrasound in diagnosis of nature of type 4 thyroid nodules by thyroid imaging reporting and data system
- VernacularTitle:超声造影在穿刺活检指导甲状腺影像报告和数据系统4类甲状腺结节性质诊断中的价值
- Author:
Hao XU
1
;
Jiaoran LIU
;
Bojian GAO
;
Rongxin ZHANG
;
Tianya WANG
Author Information
- Keywords: contrast-enhanced ultrasound; fine needle aspiration; thyroid imaging reporting and data system; thyroid nodule; pathological diagnosis; sensitivity; specificity; malignant nodule
- From: Journal of Clinical Medicine in Practice 2025;29(7):8-12
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the value of contrast-enhanced ultrasound(CEUS)guided fine needle aspiration(FNA)in diagnosing the nature of type 4 thyroid nodules by thyroid imaging re-porting and data system(TI-RADS).Methods A total of 120 patients with TI-RADS type 4 thyroid nodules were selected as subjects.Sixty patients underwent CEUS-guided FNA(CEUS group),while the other 60 patients underwent conventional ultrasound-guided FNA(conventional ultrasound group).Using pathological results as the gold standard,Kappa consistency tests were used to analyze the diagnostic consistency of conventional ultrasound-guided FNA and CEUS-guided FNA for TI-RADS type 4 thyroid nodules.Results Among 120 patients with TI-RADS type 4 thyroid nodules(138 nodules),85 malignant nodules and 53 benign nodules were confirmed by pathology.In the CEUS group,there were 28 benign nodules and 42 malignant nodules(40 papillary thyroid carcino-mas and 2 medullary carcinomas).In the conventional ultrasound group,there were 25 benign nod-ules and 43 malignant nodules(39 papillary thyroid carcinomas and 4 medullary carcinomas).The false positive rate and false negative rate of conventional ultrasound-guided FNA for diagnosing malignant TI-RADS type 4 thyroid nodules were 3.62％and 5.07％,respectively.For CEUS-guided FNA,the rates were 2.17％and 2.90％,respectively.The sensitivity,specificity and accuracy of con-ventional ultrasound-guided FNA for diagnosing the nature of TI-RADS type 4 thyroid nodules were 83.72％,80.00％and 82.35％,respectively,with Kappa value of 0.627.For CEUS-guided FNA,these values were 90.48％,89.29％and 90.00％,respectively,with Kappa value of 0.793.Based on pathological examination,the diagnostic agreement rates for malignant TI-RADS type 4 thyroid nodules were 79.07％for conventional ultrasound-guided FNA and 83.33％for CEUS-guided FNA,with Kappa values of 0.719 and 0.786,respectively.Conclusion CEUS-guided FNA can provide high-resolution,real-time dynamic imaging information,thereby improving the sensitivity and specificity of diagnosing the nature of TI-RADS type 4 thyroid nodules.
