Objective To compare the diagnostic value of artificial intelligence computer-aided diagnosis（AI-CAD） system

contrast-enhanced ultrasound（CEUS） and their combination in the thyroid nodules with the category 5 of American college of radiology thyroid imaging reporting and data system（ACR TI-RADS 5）.Methods A total of 141 thyroid nodules scored as ACR TI-RADS 5 from 93 patients who were underwent the AI-CAD and CEUS examination were selected.All nodules were confirmed by histopathological results

the diagnostic efficacy of AI-CAD

CEUS and their combination were evaluated.Results Of the 141 thyroid nodules

there were 100 malignant and 41 benign nodules diagnosed by the CEUS

and the malignant-nodules diagnostic sensitivity

specificity and accuracy were 89.7%

59.2% and 78.0%

respectively.There were 76 malignant and 65 benign nodules diagnosed by the AI-CAD

and the malignant-nodules diagnostic sensitivity

specificity and accuracy were 78.2%

85.2% and 80.9%

respectively.And there were 102 malignant and 39 benign nodules diagnosed by the combination of CEUS with AI-CAD

and the malignant-nodules diagnostic sensitivity

specificity and accuracy were 94.3%

63.0% and 82.3%

respectively.The results showed that the sensitivity and accuracy of the AI-CAD combined with the CEUS were higher than those of single method（both P<0.05）.Conclusion AI-CAD combined with CEUS has high value in the differential diagnosis of TI-RADS 5 nodules in clinic.