摘要
目的:探讨超声造影(contrast-enhanced ultrasound,CEUS)在细针抽吸活检(fine-needle aspiration biopsy,FNAB)不能明确诊断的甲状腺结节中的应用价值。方法:回顾性分析2016年1月—2018年12月在上海健康医院附属嘉定区中心医院就诊并经FNAB不能明确诊断的56例患者的CEUS资料,观察结节的造影模式,应用时间-强度曲线(timeintensitycurve,TIC)获得结节峰值强度(peakintensity,PI)、达峰时间(timetopeak,TTP)、曲线下面积(area undercurve,AUC),计算病灶与周围组织相对△PI、△TTP及△AUC。与手术后病理学检查结果对照绘制受试者工作特征(receiver operating characteristic,ROC)曲线,比较造影模式和定量参数诊断FNAB不能明确诊断的结节良恶性的价值。结果:在FNAB不能明确诊断的56例患者中共发现62个结节,经手术后病理学检查确诊甲状腺癌30个,恶性率为48.39%;CEUS增强模式、△TTP、△PI及△AUC诊断甲状腺癌的ROC曲线的AUC为0.776(95%CI:0.652～0.872)、0.651(95%CI:0.519～0.767)、0.863(95%CI:0.751～0.937)及0.799(95%CI:0.768～0.890)。以△PI诊断效能最佳,其灵敏度为83.33%、特异度为78.12%、准确率为80.62%。结论:CEUS可为FNAB不能明确诊断的甲状腺结节提供额外的评价标准,以△PI定量分析诊断效能最佳。
Objective:To investigate the value of contrast-enhanced ultrasound(CEUS)in thyroid nodules which cannot be clearly diagnosed by fine-needle aspiration biopsy(FNAB).Methods:The CEUS data of 56 patients who could not be diagnosed by FNAB in Jiading District Central Hospital,Shanghai University of Medicine and Health Sciences from Jan.2016 to Feb.2018 were retrospectively analyzed.The CEUS images of thyroid nodules were observed.The peak intensity(PI),time to peak(TTP),and area under curve(AUC)of nodules were obtained using time-intensity curve(TIC).The relative PI(△PI),TTP(△TTP),and AUC(△AUC)of the lesion to surrounding tissues were calculated.The receiver operating characteristic(ROC)curve was plotted by comparing with the surgical pathology.The comparison between CEUS and quantitative parameters for the diagnosis of nodules which FNAB could not clearly determined was performed.Results:A total of 62 nodules were found in 56 patients.Totally 30 cases of thyroid cancer were diagnosed by pathology.The malignant rate was 48.39%.The AUCs of enhancement pattern,△TTP,△PI and△AUC were 0.776(95%CI:0.652-0.872),0.651(95%CI:0.519-0.767),0.863(95%CI:0.751-0.937)and 0.799(95%CI:0.768-0.890).The diagnostic efficiency of△PI was the best.Its sensitivity was 83.33%,specificity was 78.12%,and accuracy was 80.62%.Conclusion:CEUS can provide additional evaluation criteria for nodules that cannot be clearly diagnosed by FNAB,and the diagnostic efficiency of△PI is the best.
作者
周洁
杨德斌
姚晓华
王迎春
ZHOU Jie;YANG Debin;YAO Xiaohua;WANG Yingchun(Department of ultrasound,Jiading District Central Hospital,Shanghai University of Medicine and Health Sciences,Shanghai 201800,China)
出处
《肿瘤影像学》
2019年第2期96-100,共5页
Oncoradiology
基金
上海市嘉定区农业和社会事业科研项目(JDKW-2016-W12)
上海市嘉定区医学重点学科项目(2017ZD04)
关键词
甲状腺结节
细针抽吸活检
超声造影
时间-强度曲线
Thyroid nodule
Fine-needle aspiration biopsy
Contrast-enhanced ultrasound
Time-intensity curve
