Analysis of the Influence Factors on the Differential Diagnosis Between Benign and Malignant 4-Class Thyroid Nodules by the Ratio of the Elastic Strain Rate

Objective: This study aimed to investigate the value of elastic strain rate ratio (SR) in the differential diagnosis of benign and malignant thyroid imaging reporting and data system (TI-RADS) 4 nodules under the influence of various factors. Method: This study included 180 patients with type 4 unifocal thyroid nodules diagnosed by ultrasound examination in the Xiangyang No. 1 People's Hospital from March 2016 to March 2019. All patients underwent elasticity imaging and surgical operations. The pathological results were used as the gold standard to perform logistic regression analyses and identify the factors influencing the differential diagnosis of benign and malignant thyroid nodules. Then, the receiver operating characteristic (ROC) curve was drawn. Results: The ROC curve suggested a cutoff value of 0.52 in differentiating between benign and malignant TI-RADS 4 nodules using the SR value. The nodule size, calcification, border, and thyroid gland with diffuse lesions were factors influencing the differential diagnosis of benign and malignant TI-RADS 4 nodules with the SR value. SR had a high accuracy identifying benign and malignant TI-RADS 4 nodules with a diameter of less than 0.8 cm (but >0.4 cm), no or granular calcification, nodules with blurred borders, and no thyroid gland with diffuse lesions. Conclusion: The diagnostic accuracy was improved by combining the two-dimensional ultrasound with SR determination in the differential diagnosis of benign or malignant TI-RADS 4 nodules.