Objective To analyze the clinical application value of ATA guideline

Kwak TI-RADS and ACR TIRADS ultrasound classification standard in the diagnosis of benign and malignant thyroid nodules guideline.MethodsA total of 237 patients（261 nodules）with thyroid nodules confirmed by surgery and pathology were selected from our hospital

including109 malignant nodules and 152 benign nodules. All nodules were diagnosed with different ultrasound classification standard respectively

then the ultrasonic characteristics and diagnostic efficacy were compared.ResultsThe average diameter of benign nodules[（22.34±12.94）mm]was significantly larger than that of malignant nodules[（11.38±8.81）mm]

the difference was statistically significant（t=5.378

P<0.05）. The ultrasonic characteristics of benign and malignant nodules had statistical differences in maximum diameter

very hypoechoic or hypoechoic

solid

microcalcification

aspect ratio>1

irregular edges

abnormal cervical lymph nodes

and extrathyroid invasion（all P<0.05）.When the cut-off value of Kwak TI-RADS was 4 b

the sensitivity for diagnosing malignant thyroid nodules was 96.20%

specificity was 62.80%

accuracy rate was 76.63%

and area under the curve（AUC）was 0.884. When the cut-off value of ACR TI-RADS was category 4

the diagnostic sensitivity was98.85%

specificity was 57.85%

the accuracy rate was 75.10%

and the AUC was 0.875. When the cut-off value of ATA guideline was highly suspicious

the diagnostic sensitivity was 98.08%

specificity was 61.69%

the accuracy rate was 76.63%

and AUC was 0.868.There were no statistical differences in the diagnostic sensitivity

specificity

accuracy and AUC of the three classification standards.ConclusionATA guideline

ACR TI-RADS and Kwak TI-RADS can effectively distinguish benign and malignant thyroid nodules with high sensitivity

but nodules with high risk of malignancy cannot be classified by the ATAguideline

the clinical application of ACR TI-RADS is cumbersome

and the Kwak TI-RADS classification standard is easy to operate

which has a wide range of clinical applications.