目的：探讨超声造影对甲状腺良恶性结节的诊断价值。方法对常规超声检出但定性诊断困难的69个甲状腺实性结节行超声造影检查，与手术病理结果对照，分析良恶性结节的增强模式，即造影剂进入结节时间、方式、增强程度、造影剂分布是否均匀以及结节内造影剂消退快慢的情况。结果超声造影表现：63．9％（23/36）甲状腺良性结节表现为等增强或高增强，84．8％（28/33）甲状腺癌表现为低增强或等增强。低或等增强、不均匀增强、早期消退对甲状腺乳头状癌的诊断敏感性分别为72.7%、87.9%、84.8%，良恶性结节的峰值强度、始增时间、达峰时间差异无统计学意义，但恶性结节消退时间早于良性结节（P＜0．05）。结论超声造影能为甲状腺结节良恶性鉴别诊断提供更有效的诊断方法。%Objective To explore the application value of contrast-enhanced ultrasound (CEUS)in diagnosing thyroid nodules. Methods Sixty-nine thyroid solitary nodules detected by conventional ultrasonography were underwent CEUS.All the nodules were confirmed by pathology.The enhancement patterns of nodules were evaluated in comparison with adjacent thyroid parenchyma.The evaluation criterions were as following:the time and the pattern of contrast up-take,contrast intensity,contrast-enhancement distribution(homogeneous or inhomogeneous),contrast wash-out early or not. Results The thyroid benign nodules which showed iso-enhancement or hyper-enhancement accounting for 63.9%,the thyroid papillary carcinoma which showed heterogeneous hypo-enhancement or iso-enhancement accounting for 84.8%.The sensitivities of hypo-enhancement or iso-enhancement,uneven enhancement and early regression for the diagnosis of thyroid nodules were 72.7%,87.9% and 84.8%, respectively. No significant differences were found in peak intensity,starting and peak time between benign and malignant nodules. Conclusion Contrast-enhanced ultrasound can provide more effective differential diagnosis of benign and malignant thyroid nodules.
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