The application value of ultrasound elastic strain ratio in diagnosing calcified thyroid nodules of TI-RADS (4-6) categories

DENG Hong-yan; YE Xin-hua; LIN Hong-jun

Abstract：Objective To explore the application value of ultrasound elastic strain ratio in differential diagnosing calcified thyroid nodules of TI‐RADS(4‐6) categories .Methods Conventional ultrasound was applied to 324 thyroid nodules (from 303 patients) to observe their sizes ,margins ,echoes ,presence of calcification ,aspect ratio and interior and ambitus bloodstream .The thyroid nodules were classified into groups according to the thyroid imaging reporting and data system (TI‐RADS) ,then underwent ultrasonic elastography and the strain ratios of them were recorded .A receiver‐operating characteristic curve (ROC) was drawn to identify the cut‐off point in the differential diagnosis of thyroid nodules .The 137 thyroid nodules(from 137 patients) of TI‐RADS 4‐6 categories were classified into two groups :groupⅠ (calcification group) and groupⅡ (no calcification group) .Calcification group was classified into micro‐calcification group and coarse calcification group according to the size of calcification (≤2 mm) .Pathologic results were taken as the gold standard .A ROC curve was drawn to evaluate the application value of strain ratio in group Ⅰ and group Ⅱ .Results The boundary values or strain ratio was 0 .55 .The sensitivity ,specificity ,accuracy and positive predictive value in micro‐calcification and group Ⅱ were 88 .9% ,71 .4% ,86 .5% ,95 .2% and 82 .4% ,78 .9% ,81 .1% ,87 .5% respectively .The area under the curve (AUC) in micro‐calcification group ,coarse calcification group and group Ⅱ were 0 .808 ,0 .655 and 0 .831 respec‐tively .Conclusion The joint application of TI‐RADS and strain ratio can improve the sensitivity ,accuracy and specificity of strain ratio in the differential diagnosis of thyroid nodules in group Ⅱ and the micro‐calcification group ,and provide guidance in treating calcified thyroid nodules ,which is helpful in achieving the goal of early diagnosis and early treatment .