结节性甲状腺肿超声造影特征与病理微血管密度的相关性

Relationship between contrast-enhanced ultrasound characteristics and microvessel density of nodular goiter

目的探讨结节性甲状腺肿的超声造影增强特征,分析超声造影定量参数与病理微血管密度的相关性。方法回顾性分析30例结节性甲状腺肿患者的超声造影过程,并用Tom Tec软件绘制时间—强度曲线(TIC曲线)获得定量参数。对术后石蜡标本切片进行免疫组化染色测定微血管密度,并与超声造影定量参数进行相关性分析。结果 30例病灶中23例表现为与周围甲状腺实质等增强,4例高增强,3例低增强,内部增强区回声多均匀。其TIC曲线各定量参数与周围甲状腺组织比较差异无统计学意义。造影参数始增时间(RT)、达峰时间(TTP)、平均渡越时间(m TT)与微血管密度呈显著负相关,最大峰值强度(IMAX)与微血管密度呈显著正相关。结论等增强是诊断结节性甲状腺肿重要的超声造影增强模式,免疫组化染色为超声造影诊断结节性甲状腺肿提供了病理依据。

Objective To investigate the performance of nodular goiter with contrast-enhanced ultrasound（CEUS）, and to analyze the relationships between CEUS quantitative parameters and microvessel density （MVD）. Methods The CEUS presentations of 30 patients with nodular goiter were retrospectively analyzed, the time-intensity curve （TIC） was analyzed by TomTec software. Immunohistochemical staining was performed to evaluate the MVD in surgical specimens,Quantitative parameters and MVD were assessed by the Spearman＇s Rank correlation analysis. Results Twenty-three nodules showed isoenhancement,4 nodules showed hyperenhancement,3 nodules showed hypoenhancement. Homogeneous enhancement was observed in most nodules. Compared with the surrounding thyroid tissue,there was no obvious statistic difference of the quantitative parameters. Rise time （RT）, time to peak （TIP）, mean transit time （mTT） and MVD showed negative correlations, maximum intensity （IMAX） and MVD showed positive correlation. Conclusion Isoenhencement is an important CEUS enhancement pattern to diagnose nodular goiter, immunohistochemical staining provides pathologic bases for diagnosis of nodular goiter with CEUS.