Tianjin Medical Journal ›› 2023, Vol. 51 ›› Issue (5): 535-539.doi: 10.11958/20220618

• Applied Research • Previous Articles     Next Articles

The value of C-TIRADS and superb microvasular imaging in the differential diagnosis of thyroid nodules with Hashimoto's thyroiditis

LIU Weiliang(), LU Haiyong, ZHENG Yingjuan, LI Chaoxi, WEN Dehui()   

  1. Department of Ultrasound Medicine, the First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, China
  • Received:2022-07-01 Revised:2022-11-15 Published:2023-05-15 Online:2023-05-05
  • Contact: △E-mail:lucky0726cindy@163.com

Abstract:

Objective To explore the value of C-TIRADS and superb microvasular imaging (SMI) in diagnosing the characteristics of thyroid nodules with Hashimoto's thyroiditis (HT). Methods A total of 272 patients with HT combined with thyroid nodules were included in this study. All nodules and thyroid parenchyma were detected by two-dimensional ultrasonography and SMI respectively before operation. The ultrasound characteristics of nodules and blood flow of thyroid parenchyma were analyzed. All nodules were graded by C-TIRADS. The diagnostic efficacy of two-dimensional ultrasonography and two-dimensional ultrasonography combined with SMI was evaluated. Results There were 124 benign nodules in 113 patients (the benign group) and 178 malignant nodules in 159 patients (the malignant group). The proportion and age of females were higher in the malignant group than those in the benign group (P<0.05). There was no significant difference in the average size of nodules between the two groups. Malignant nodules were mostly solid hypoechoic or very hypoechoic, accompanied by external thyroid invasion and strong focal echo. Benign nodules were mostly hyperechoic and isoechoic nodules without focal hyperechoic. The blood supply type was no obvious change or slightly increased in the malignant group, and the benign group showed mainly moderately increased and no obvious change or slightly increased. The malignant rates calculated by C-TIRADS were all within the recommended range of malignant rates. Results of ROC curve showed that the best diagnostic cut-off point of C-TIRADS was C-TIRADS 4C. The best diagnostic cut-off point C-TIRADS combined with SMI was C-TIRADS 4C, and the blood supply of thyroid parenchyma was not significantly changed or slightly increased. Specificity and accuracy were higher in C-TIRADS combined with SMI than those of C-TIRADS (P<0.05). There was no significant difference in the specificity and accuracy between C-TIRADS combined with SMI and C-TIRADS (P>0.05). Conclusion C-TIRADS combined with SMI can improve the diagnostic efficiency of HT complicated with nodules.

Key words: Hashimoto's thyroiditis, thyroid nodules, thyroid parenchyma, C-TIRADS, superb microvasular imaging

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