TI-RADS 4类甲状腺结节患者的超声弹性应变率比值与结节性质的关联OACSTPCD

OBJECTIVE To investigate the relationship between the ultrasonic elastic strain rate ratio(SR)and the nodule properties of thyroid nodules in patients with thyroid imaging reporting and data system(TI-RADS).METHODS Ninety-five patients with thyroid nodules(128 nodules in total)who received treatment in Hanyang Hospital,Wuhan University of Science and Technology from January 2018 to February 2023 were selected for the study,and they were divided into benign group(n=50)and malignant group(n=45)according to the pathological examination results,and the general data of the two groups were compared.LASSO regression and multivariable logistic regression were used to analyze the risk factors affecting the nodule properties of patients.SR was divided into a 5-quartile array(Q1-Q5)from low to high.Clinical characteristics of the 5 groups were compared,and the correlation between SR and the risk of malignant nodules was analyzed with multivariable logistic regression.A restricted cubic spline Logistic regression model was established to analyze the dose-response relationship.The nonlinear association between SR and the risk of central lymph node metastasis of malignant thyroid nodules was analyzed by restricted cubic spline regression.The prediction model of regression equation y=1-1/(1+e-z)was established and verified.RESULTS There were significant differences in end-diastolic blood flow velocity(EDV),thyroid stimulating hormone(TSH),peak systolic blood flow velocity(PSV),resistance index(RI)and SR between benign and malignant groups(P<0.05).LASSO regression and multivariable logistic regression analysis showed that after adjusting for potential confounding factors,the increase of TSH,PSV,RI,and the decrease of EDV and SR were independent risk factors affecting the nodule features of the patients(P<0.05).There was an independent correlation between SR and the risk of malignant nodules(OR=0.60,95%CI 0.41-0.81,P<0.001),and the difference of SR from low to high quintile array trend test was statistically significant(Pfor trend<0.001).Restricted cubic spline model analysis showed that there was no nonlinear relationship between SR and the risk of malignant nodules in either males or females.Limited cubic spline regression analysis showed that SR was significantly associated with the risk of central lymph node metastasis of malignant thyroid nodules.SR=-2.1,the curve had a zenith and a long tail to the right,with a linear P of P<0.0001.Through Bootstrap self-sampling,the prediction model had good differentiation and accuracy.CONCLUSION There is an independent correlation between SR and nodule properties in patients with TI-RADS 4 thyroid nodules.SR can judge the nodule properties by the hardness of lesion tissue,and has a good prediction value for the nodule properties of patients.