title: Usefulness of combined use of contrast-enhanced ultrasound and TI-RADS classification for the differentiation of benign from malignant lesions of thyroid nodules.
abstract: OBJECTIVE
  To study the thyroid image reporting and data system (TI-RADS) classification and the contrast-enhanced ultrasound (CEUS) enhancement pattern of thyroid nodules, and to determine whether combined use of both methods is helpful in the diagnosis of thyroid nodules.
  
  
  METHODS
  A total of 319 thyroid nodules in 246 patients were assessed with TI-RADS, CEUS and a combination of both methods. The diagnostic performance of TI-RADS, CEUS and a combination of both methods was compared.
  
  
  RESULTS
  The accuracy in the diagnosis of thyroid nodules was 90.3 % for TI-RADS, 90.0 % for CEUS and 96.0 % for a combination of both methods respectively. A statistically significant difference was not observed in the diagnostic accuracy of CEUS and TI-RADS (P > 0.05). However, a significant difference was observed between a combination of both methods and either alone (P < 0.01). A combination of both methods showed high sensitivity, specificity and accuracy for TI-RADS classifications of 4a and 4b thyroid nodules compared with TI-RADS alone (P < 0.01) and a statistically significant difference was not observed for thyroid nodules classified as 2, 3, and 5 (P > 0.05).
  
  
  CONCLUSIONS
  The improved TI-RADS, when combined with CEUS, could significantly improve the diagnostic accuracy for thyroid nodules, especially for TI-RADS class-4 thyroid nodules.
  
  
  CONCLUSIONS
  • TI-RADS can be used as the primary diagnostic standard for thyroid nodules • CEUS can be used as an important complement to TI-RADS • The improved TI-RADS can significantly improve the qualitative diagnostic accuracy.
authors.affiliation: Department of Ultrasound, The Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Ultrasound, The Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, China. zhouping1000@hotmail.com.
authors.forename: Ping
authors.initials: P
authors.lastname: Zhou
authors.affiliation: Department of Ultrasound, The Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, China.
authors.forename: Shuang-Ming
authors.initials: SM
authors.lastname: Tian
authors.affiliation: Department of Ultrasound, The Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, China.
authors.forename: Yong-Feng
authors.initials: YF
authors.lastname: Zhao
authors.affiliation: Department of Ultrasound, The Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, China.
authors.forename: Jia-Le
authors.initials: JL
authors.lastname: Li
authors.affiliation: Department of Ultrasound, The Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, China.
authors.forename: Lan
authors.initials: L
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011873:Radiology Information Systems; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013961:Thyroid Gland / Q000000981:diagnostic imaging; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: Combination; Contrast-enhanced ultrasound; Improved TI-RADS; TI-RADS; Thyroid nodules