The role of microflow patterns combined with greyscale ultrasound in enhancing diagnostic validity and reducing unnecessary biopsy rate of thyroid nodules

作者：Wanying Li, Luying Gao, Yahong Wang, Min Zhang, Yiyan Du, Hongyan Wang, Jianchu Li · 发表于：European Radiology · 年份：2025 · DOI：10.1007/s00330-025-11963-w · 被引用次数：4 · 研究领域：Thyroid Cancer Diagnosis and Treatment、Thyroid Disorders and Treatments、Head and Neck Anomalies

OBJECTIVE: To explore the value of microflow patterns based on superb microvascular imaging (SMI) combined with greyscale ultrasound in thyroid nodule diagnosis and biopsy recommendation. MATERIALS AND METHODS: Adult patients with thyroid nodules were recruited from May 2023 to February 2024. The greyscale features of nodules were evaluated according to the five ultrasound risk stratification systems (RSSs). The microflow patterns on SMI were used to adjust the category of nodules. The crab claw-like and the root hair-like patterns were malignant signs for upgrading, with the wheel-like and the arborescent patterns for downgrading. The diagnostic performance and biopsy recommendation of microflow patterns combined with greyscale ultrasound were analyzed. RESULTS: A total of 253 nodules (136 malignant, 117 benign) in 203 patients were included. Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) owned the best diagnostic sensitivity and the largest AUC, with no significant improvement for the former (0.853 vs 0.904, p = 0.096) but an evident increase for the latter (0.834 vs 0.900, p < 0.001) when combined with SMI. American College of Radiology (ACR) TI-RADS had the highest specificity, which was further enhanced by SMI (0.803 vs 0.855, p = 0.041). The unnecessary biopsy rates of RSSs were reduced by 1.27-20.30% according to microflow patterns on SMI. Among these, C-TIRADS had the lowest unnecessary biopsy rate and the largest reduction after the adjustment by SMI (3...