高频超声、弹性成像及超声造影对甲状腺良恶性结节的诊断

Diagnosis of thyroid benign and malignant nodules by high frequency ultrasonic,elastography,ultrasound contrast

目的 探讨高频超声、弹性成像及超声造影对甲状腺良恶性结节诊断结果情况。方法 分析抚顺市中心医院超声科2012年5月～2014年6月甲状腺结节患者168例的临床资料,分别通过高频超声、弹性成像及超声造影检查,100例良性结节,68例恶性结节。结果 高频超声声像图在良恶性鉴别有意义的是病变内部结构、内部回声情况、形状、边界清晰度、周边声晕规则性、钙化程度（均P〈0.05）。良性结节弹性成像分级Ⅰ、Ⅱ级比例（90.0%）明显高于恶性结节（14.7%）,良性结节弹性成像分级Ⅲ、Ⅳ级比例（10.0%）明显低于恶性结节（85.3%）,实性病变内部结构、低回声、不规则形状、不清晰边界、不规则周边声晕、微钙化声像图特征是区别良恶性重要的指标,良性甲状腺结节不均匀增强模式比例（10.0%）明显低于恶性结节（75.0%）,良性甲状腺结节环形增强（65.0%）明显高于恶性结节（1.5%）,差异均有统计学意义（P〈0.05）。结论 高频超声、弹性成像及超声造影对甲状腺良恶性结节诊断具有重要的价值,可以为甲状腺良恶性结节鉴别诊断提供可靠的理论依据。

Objective To approach diagnosis of thyroid benign and malignant nodules by high frequency ultrasonic, e- lastography, ultrasound contrast. Methods Clinical data of 168 cases with thyroid benign and malignant nodules in De- partment of Ultrasound in Fushun Central Hospital from May 2012 to June 2014 was observed by high frequency ultra- sonic, elastography, ultrasound contrast. Benign nodules were 100 cases, Malignant nodules were 68 cases. Results The identify meaningful of benign and malignancy in high frequency ultrasonic ultrasonographic, which was interior struc- ture, echo, shape, boundary definition, acoustic halo surrounding the regularity, calcification degree （P 〈 0.05）. The E- lasticity imaging classification I,Ⅱ proportion of benign nodules （90.0%） was higher than malignant nodules （14.7%）, the elasticity imaging classification Ⅲ, Ⅳ proportion of benign nodules （10.0%） was higher than malignant nodules （85.3%）, internal structure of solid lesions, low echo-level, irregular shape, in-defined boundary, irregular peripheral halo, micro calcification sonographic features were important index in difference between benign and malignant. The diagnostic observation of thyroid benign and malignant nodules by high frequency ultrasonic, elastography, ultrasound contrast were different between benign and malignant important indicator. Uneven enhancement pattern of benign thy- roid nodules （10.0%） were lower than malignant nodules （75.0%）, annular enhancement of benign thyroid nodules （65.0%） were higher than malignant nodules （1.5%）, the differences were statistically significant （P 〈 0.05）. Conclusion The diagnostic observation of thyroid benign and malignant nodules by high frequency ultrasonic, elastography, ultra- sound contrast has an important value, which is to be provided reliable theory basis for differential diagnosis of thyroid benign and malignant nodules.