超声造影检查在甲状腺乳头状癌中的灌注参数特征和诊断价值

Perfusion Parameter Characteristics and Diagnostic Value of Contrast-enhanced Ultrasound in Patients with Papillary Thyroid Carcinoma

【目的】探讨超声造影(CEUS)检查在甲状腺乳头状癌(PTC)中的灌注参数特征和诊断价值。【方法】回顾性分析在西安市第九医院和陕西省肿瘤医院诊治的、经病理学检查证实的PTC患者90例(PTC组)、甲状腺良性结节患者90例(良性组)的临床资料,均采用CEUS检查,对比两组患者的CEUS时间-强度曲线参数峰值强度(PEAK)、峰值时间(TTP)、局部血容量(RBV)、局部血流量(RBF)、最大灌注强度(SImax)、平均灌注强度(SImean)、CEUS增强模式变化及其在PTC中的诊断价值。【结果】PTC组患者PEAK、RBF、SImax、SImean值均显著低于良性组,其差异具有统计学意义(P<0.05);PTC组患者TTP、RBV值与良性组比较差异无统计学意义(P>0.05);PTC组患者增强模式中均匀增强、增强强度、早期消退情况与良性组比较差异均无统计学意义(P>0.05)。以病理学结果作为金标准,CEUS鉴别诊断PTC与甲状腺良性结节的灵敏度为94.44%(85/90),特异度为86.67%(78/90),阳性预测值为87.63%(85/97),阴性预测值为93.98%(78/83)。【结论】根据CEUS的灌注参数特征,CEUS在PTC与甲状腺良性结节诊断中具有较高的灵敏度和特异度,值得临床推广应用。

【Objective】To investigate the value of contrast-enhanced ultrasound(CEUS)in the diagnosis of papillary thyroid carcinoma(PTC).【Methods】Ninety patients with PTC confirmed by pathology(the PTC group)and 90 patients with benign thyroid nodules(the control group)were enrolled in our hospital.CEUS was used to compare the peak intensity of contrast-enhanced curve-intensity curve between the two groups(PEAK),peak time(TTP),local blood volume(RBV),local blood flow(RBF),maximum perfusion intensity(SImax),mean perfusion intensity(SImean),and contrast-enhanced ultrasound mode results.【Results】The values of PEAK,RBF,SImax and SImean in the PTC group were lower than those in the control group(P<0.05).TTP and RBV values in the PTC group were not significantly different from those in the control group(P>0.05).There was no significant difference in the uniform enhancement,enhancement intensity,and early regression between the PTC group and the control group(P>0.05).If the gold standard for diagnosis was determined by pathological results,then the sensitivity of CEUS in differential diagnosis of PTC and benign thyroid nodules was 94.44%and the specificity was 86.67%.【Conclusion】According to the characteristics of CEUS perfusion parameters,CEUS has higher sensitivity and specificity in differential diagnosis of PTC and benign thyroid nodules.