摘要
目的应用超声造影技术观察甲状腺结节的超声造影特征,分析甲状腺良恶性结节的超声造影表现,评估超声造影对甲状腺结节良恶性的诊断价值。方法选取2016年8月—2017年8月在河北省人民医院超声科行超声造影检查的甲状腺结节患者86例104个结节。以手术病理为"金标准"及甲状腺细针抽吸活检(FNA)细胞学结果 +超声随访为参考标准,分析甲状腺恶性结节的超声造影表现,评估超声造影对甲状腺结节良恶性的诊断价值。结果 104个结节中恶性50个,良性54个。甲状腺良恶性结节超声造影增强水平、增强形态、增强均匀性、增强后边界、增强模式、退出模式差异均有统计学意义(χ~2=29. 208、26. 610、21. 007、16. 840、13. 078、33. 259,P均<0. 001);甲状腺恶性结节典型超声造影征象为低增强、向心性增强、不均匀增强、增强后结节边界不清晰、廓清时间早于周边甲状腺组织。Logistic回归分析得出,向心性增强、不均匀增强、廓清时间早于周边甲状腺组织与甲状腺恶性结节相关(P <0. 01),绘制ROC曲线,曲线下面积(AUC)为0. 898,其诊断甲状腺恶性结节敏感度为92. 0%,特异度为74. 0%,准确率为82. 7%。结论甲状腺恶性结节有较为典型的超声造影表现,超声造影有助于甲状腺良恶性结节的鉴别诊断。
Objective Contrast-enhanced ultrasound (CEUS) was used to observe the characteristics in thyroid nodules. Analysis the ultrasound contrast of benign and malignant thyroid nodules,and to evaluate the diagnostic value of contrastenhanced ultrasound in the benign and malignant thyroid nodules. Methods A total of 104 nodules were enrolledin this study,Contrast-enhanced ultrasound was performed on 104 nodules of 86 patients with thyroid nodules. Based on operative pathology as the " golden standard" and fine needle aspiration biopsy (FNA) benign results combineultrasound follow up as the reference standard,Analysis the ultrasound contrast of benign and malignant thyroid nodules,and to evaluate the diagnostic value of contrast-enhanced ultrasound in the benign and malignant thyroid nodules. Results There were significant differences in contrast enhanced ultrasound,enhanced morphology,enhanced homogeneity,enhanced border,enhanced mode and exit mode between benign and malignant thyroid nodules (χ^2= 29. 208,26. 610,21. 007,16. 840,13. 078,33. 259,P < 0. 001). Typical ultrasonography signs of thyroid malignant nodules were Low enhancement,centripetal enhancement,inhomogeneous enhancement,unclear boundary of the posterior nodule,and clearance time were earlier than that of the peripheral thyroid tissue. Logistic regression analysis showed that the centripetal enhancement,uneven enhancement,and the clearance time earlier than the perimeter thyroid tissue were Associated with thyroid malignant nodules (P < 0. 01). The ROC area is 0. 898. The sensitivity of the diagnosis of thyroid malignant nodules was 92. 0%,the specificity was 74. 0%,and the accuracy was 82. 7%.Conclusion The thyroid malignant nodules have typical contrast-enhanced ultrasound findings,and contrast-enhanced ultrasound is helpful for the differential diagnosis of benign and malignant thyroid nodules.
作者
薛红元
姜紫韵
赵荣梅
李丽
郭磊
叶玉泉
XUE Hongyuan;JIANG Ziyun;ZHAO Rongmei;LI Li;GUO Lei;YE Y uquan(Department of Ultrosound,Hebei General Hospital,Shijiazhuang 050051,China)
出处
《疑难病杂志》
CAS
2018年第12期1366-1369,F0003,共5页
Chinese Journal of Difficult and Complicated Cases
基金
河北省科技支撑计划项目(No.16277730D)
关键词
甲状腺结节
良性结节
恶性结节
超声造影
鉴别诊断
Thyroid nodules
Benign nodules
Malignant nodules
Contrast-enhanced ultrasound
Differential diagnosis
