Objective: To explore the application value of thyroid TI-RADS classification combined with ultrasound-guided fine needle aspiration (FNA) cell smear in the identification and diagnosis of benign and malignant thyroid nodules. Methods: A total of 1 038 patients with thyroid nodules who were treated in our hospital and The First Affiliated Hospital of Chengdu Medical College from June 2018 to February 2020 were selected in the study. Patients were randomly divided into 2 groups

with 519 patients in each group (control group and observation group). The control group underwent thyroid TI-RADS classification guided FNA cell smear examination

and the observation group underwent contrast-enhanced ultrasound examination on this basis. The success rate of the two groups of materials and the diagnostic efficiency of the two methods of guiding materials in the differentiation of benign and malignant thyroid nodules were compared. Results: The success rate of sampling in the observation group was 93.45%

which was higher than 75.34% in the control group (P<0.05). The consistency of FNA cell smear detection and histopathological diagnosis under the guidance of thyroid TI-RADS classification was poor

with Kappa value of 0.365 (P<0.05)

and the diagnostic sensitivity

specificity and accuracy were 74.42% (64/86)

71.80% (219/305) and 72.38% (283/391)

respectively. FNA cell smear detection and histopathological diagnosis under the guidance of thyroid TI-RADS classification combined with contrast-enhanced ultrasound were in good agreement with histopathological diagnosis

with Kappa value of 0.785 (P<0.05)

and the diagnostic sensitivity

specificity and accuracy were 91.80% (112/122)

90.63% (329/363) and 90.93% (441/485)

respectively. The sensitivity

specificity and accuracy of the observation group were higher than those of the control group (P<0.05). Conclusion: Thyroid TI-RADS classification combined with contrast-enhanced ultrasound to guide FNA cell smears can effectively improve the success rate of identifying benign and malignant thyroid nodules compared with thyroid TI-RADS classificationalone. This method is simple to operate with higher diagnostic sensitivity

specificity and accuracy

and of great clinical value.