甲状腺微小乳头状癌超声造影增强模式定量分析

Quantitative analysis of enhancement patterns of papillary thyroid microcarcinoma in contrast-enhanced ultrasound

目的探讨甲状腺微小乳头状癌(PTMC)的超声造影增强模式特征。方法选取自2017年10月至2019年10月于北部战区总医院行细针穿刺活检或手术切除并经病理证实的60例(60枚结节)PTMC患者为研究对象。用QLAB软件分析所有PTMC结节各感兴趣区的时间-强度(TIC)曲线,获得定量参数,包括始增时间(AT)、达峰时间(TTP)、峰值强度(PI)、曲线下面积(AUC)。比较PTMC与周围正常甲状腺组织及PTMC结节中心区域与边缘区域的TIC曲线定量参数。结果PTMC超声造影定量参数PI及AUC均低于正常组织,差异有统计学意义(P<0.05)。PTMC结节中心区域超声造影定量参数AT高于PTMC结节边缘区域,PI、AUC低于PTMC结节边缘区域,差异有统计学意义(P<0.05)。结论PTMC增强模式以向心性低增强为特征性表现。

Objective To investigate the contrast-enhanced patterns of papillary thyroid microcarcinoma(PTMC)in contrast-enhanced ultrasound(CEUS).Methods A retrospective study was performed on 60 cases(60 nodules)of patients with PTMC nodules who were admitted and underwent fine needle aspiration biopsy or surgical excision from October 2017 to October 2019.QLAB software was used to analyze time-intensity curves(TIC curves)of all PTMC nodules in each region of interest,and quantitative parameters were obtained,including arrival time(AT),time to peak(TTP),peak intensity(PI)and area under curve(AUC).The TIC curve parameters of PTMC and the surrounding normal thyroid tissue,and the central and marginal regions of PTMC nodules were compared.Results The quantitative parameters of PTMC PI and AUC were lower than normal tissues,and the difference was statistically significant(P<0.05).The quantitative parameters of CEUS in the central region of PTMC nodule were higher than those in the peripheral region of PTMC nodule,and PI and AUC were lower than those in the peripheral region of PTMC nodule(P<0.05).Conclusion PTMC enhancement pattern is characterized by low centripetal enhancement.