Efficiency of 2017 ACR-TIRADS combined with contrast-enhanced ultrasound in diagnosing thyroid malignant nodules

<title>Abstract</title> Objective The aim of this study was to compared the efficiency of 2017 ACR-TIRADS and contrast-enhanced ultrasound (CEUS) in diagnosing malignant thyroid nodules, and proposed a new classification system based on CEUS and 2017 ACR-TIRADS. Method A total of 788 thyroid nodules which examined by conventional ultrasound and CEUS were analyzed. The efficacy of contrast parameters in the diagnosis of benign and malignant thyroid nodules was analyzed by univariate factor and logistic regression. The contrast parameters were assigned according to the results of logistic regression analysis, and then a new classification system was proposed. Results 1)The result of univariate analysis showed non-uniformity enhancement, hyper- enhancement, fast entry, and rewind down were significant differences between benign and malignant nodules. 2)When taking ≥ 7 points as the cutoff value for the diagnosis of malignant thyroid nodules, the sensitivity and specificity of 2017 ACR-TIRADS were 87.27% and 55.06%, respectively; while that of the combined CEUS and ACR-TIRADS were 86.41% and 57.30%, respectively; 3) Enrolled the 2 points of CEUS into the 2017 ACR-TIRADS assignment process and established a new grading system, namely CEUS-TIRADS, while the sensitivity and specificity of CEUS-TIRADS were 87.27% and 57.30% respectively. Conclusion The combined application of CEUS and 2017 ACR-TIRADS had better diagnostic efficiency than that of application alone. The CEUS-TIRADS provided us with a new research direction, that is, to analyze the quantitative and qualitative data of CEUS through prospective research and establish the CEUS classification system of thyroid nodules. Advances in knowledge The combined application of CEUS and 2017 ACR-TIRADS provided us with a new research direction, that is, to establish the CEUS classification system of thyroid nodules.