[The value of ACR-TIRADS and C-TIRADS in the diagnosis of nodular Hashimoto thyroiditis and papillary thyroid carcinoma with Hashimoto thyroiditis]

Objective:To explore the diagnostic value of American Society of Radiology Thyroid Imaging Reporting and Data System（ACR-TIRADS） and Chinese Thyroid Nodule Ultrasound Malignant Risk Stratification（C-TIRADS） in nodular Hashimoto thyroiditis and papillary thyroid carcinoma with Hashimoto thyroiditis. Methods:This retrospective analysis included 144 patients（204 thyroid nodules） accompanied by nodular Hashimoto thyroiditis or papillary thyroid carcinoma under the background of Hashimoto thyroiditis confirmed by surgical pathology examination in the First Affiliated Hospital of Hebei North University from August 2018 to May 2021, all nodules were examined by ultrasound, and 204 nodules were scored and graded according to the classification standards of ACR-TIRADS and C-TIRADS. The surgical pathological results were the gold standard. The receiver operating characteristic curve of ACR-TIRADS and C-TIRADS was constructed to evaluate and compare the diagnostic performance of the two guideline. Results:①Ultrasound feature results showed that nodular Hashimoto thyroiditis and Papillary thyroid carcinoma had statistically significant differences in the location, echogenicity, calcifications and margins（P<0.001）, but there is no significant difference in structure and aspect ratio between the two kinds of nodular（P=0.141, P=0.240）; nodular Hashimoto thyroiditis were mostly absent focal echogenicity and hyperechogenicity, while papillary thyroid carcinoma was mostly manifested as focal echogenicity and extrinsic thyroid invasion. ②The sensitivity and negative predictive value of C-TIRADS were 91.7% and 83.1%, respectively, which were higher than those of ACR-TIRADS, and the difference was statistically significant（P=0.021, P=0.013）; The specificity and positive predictive value of C-TIRADS T were 98.3% and 99.2%, both of which were slightly higher than ACR-TIRADS, althought the difference was not statistically significant（P=0.157, P=0.062）. The area under the curve of the ACR-TIRADS and C-TIRADS were 0.806 and 0.941, respectively, and the difference was statistically significant（P=0.031）. ③The unnecessary FNAB rate of C-TIRADS was 10.3%, which was lower than ACR-TIRADS. Conclusion:C-TI-RADS has a better diagnostic value of nodular Hashimoto thyroiditis and thyroid papillary carcinoma under the background of Hashimoto thyroiditis, which is helpful for clinical evaluation of such nodules.