定量分析在不同超声造影特征甲状腺结节良恶性鉴别诊断中的价值

摘要

Objective This study aims to investigate the value of quantitative analysis of contrast-enhanced ultrasound (CEUS) in the diagnosis of thyroid nodules under different enhancement patterns. Methods A total of 69 patients with 77 thyroid nodules undergoing CEUS were recruited. The quantitative parameters of nodules and the adjacent thyroid tissues such as peak intensity (PI), time to peak (TP), area under the curve (AUC) and mean transit time (MTT) were obtained. Two groups, hyper-enhancement group and hypo-enhancement group were established by the PI. Results Compared with hyper-enhancement group, the rate of malignant nodules was higher in hypo-enhancement group (65.7% in hypo-enhancement group VS. 29.4% in hyper-enhancement group, P=0.002). In the hypo-enhancement group, the rate of papillary carcinomas with the size less than 2.0 cm was significant higher than that in the hyper-enhancement group (80.8% in hypo-enhancement group VS. 36.4% in hyper-enhancement group, P=0.018). In the hypo-enhancement group, the AUC in benign nodules were significant higher than malignant nodules, no significant differences were noted in other parameters. In the hyper-enhancement group, there were no significant differences in all parameters between benign nodules and malignant nodules. Conclusion Hypo-enhancement is the common enhancement pattern of malignant thyroid nodules. The major enhancement mode of thyroid papillary carcinomas with the size more than 2.0 cm presents as hyper-enhancement. Quantitative analysis of hypo-enhancement thyroid nodules on CEUS is efficient in the differential diagnosis of thyroid nodules.%目的 探讨定量分析在不同超声造影特征甲状腺结节良恶性鉴别诊断中的价值.方法 对69例患者共计77个甲状腺结节的超声造影动态录像资料进行定量分析,取得所有结节与其邻近正常甲状腺组织的峰值强度(PI)、达峰时间(TP)、曲线下面积(AUC)及平均通过时间(MTT)等定量参数.根据PI值分为高增强组和低增强组,比较两组结节中恶性结节所占比率及定量参数之间的差异.结果 低增强组中恶性病变的比率(66.6%)明显高于高增强组(28.9%)(P=0.002).低增强组中结节最大直径小于2.0 cm的比率(80.8%)显著高于高增强组(36.4%)(P=0.018).低增强组中良性病变AUC大于恶性病变(P<0.05).高增强组中定量参数均无统计学意义.结论 低增强为甲状腺恶性结节的常见超声造影表现;最大直径大于2.0 cm的甲状腺乳头状癌多表现为高增强;甲状腺超声造影定量分析在超声造影表现为低增强的甲状腺结节的良恶性鉴别中具有一定的价值.