To explore the clinical application value of ultrasound TI-RADS classification and fine needle aspiration biopsy in the diagnosis of malignant thyroid nodules.

A retrospective analysis of 588 thyroid nodules in 585 patients with TI-RADS classification≥3 in routine thyroid ultrasound examinations in our hospital from January 2020 to December 2020. All patients underwent thyroid fine-needle aspiration cytology biopsy. Among them, 266 thyroid nodules were surgically removed. Using gross pathology as the gold standard, to evaluate the efficacy of ultrasound TI-RADS classification and fine-needle aspiration biopsy in diagnosing malignant thyroid nodules.

Among 588 thyroid nodules in 585 patients, 243 cases were malignant, 193 cases were benign, and 152 cases were uncertain. The positive rates of ultrasound TI-RADS 3, 4, and 5 thyroid malignant nodules were 3.01% (4/133), 38.87% (110/283), 75.00% (129/172), respectively. 266 nodules were surgically removed, gross pathological results were available 211 malignant and 55 benign. The sensitivity, specificity, and accuracy of fine-needle aspiration biopsy in the diagnosis of malignant thyroid nodules were 98.46%, 93.02%, and 97.48%, respectively. The positive predictive value was 98.46%, the negative predictive value was 93.02%, the positive likelihood ratio was 14.11 and the negative likelihood ratio was 0.017. The accuracy of diagnosing thyroid malignant nodules with hard puncture feeling and grit sensation was significantly higher than that with soft puncture feeling and no grit sensation, and the difference was statistically significant (χ² = 70.206, 65.083; P = 0.000, 0.000).The areas under the ROC curve of ultrasonic TI-RADS classification and fine-needle aspiration biopsy for the diagnosis of malignant thyroid nodules were 0.881 and 0.954, respectively.

UltrasoundTI-RADS classification combined with fine-needle aspiration biopsy has higher diagnostic value for malignant thyroid nodules, which can distinguish benign and malignant thyroid nodules more accurately and safely, and is worthy of clinical promotion.