超声造影对伴有钙化甲状腺结节的诊断价值

Study on significance of contrast-enhanced ultrasound in diagnosis of calcified thyroid nodules

目的探讨超声造影在伴有钙化的甲状腺结节诊断中的临床价值。方法对73例甲状腺良性结节和53例甲状腺恶性结节患者分别进二维超声和超声造影检查,比较良恶性结节微钙化、弱增强及不均匀增强的构成比,并比较超声造影时良恶性结节始增时间、达峰时间和峰值强度。结果伴有钙化的甲状腺恶性结节微钙化、弱增强及不均匀增强的构成比均高于良性结节(P<0.05);超声造影恶性结节峰值强度低于良性结节(P<0.05),良恶性结节始增时间、达峰时间差异无统计学意义(P>0.05);超声造影对伴有钙化甲状腺结节良恶性诊断的敏感度、特异度、阳性预测值及阴性预测值均高于二维超声检查(P<0.05)。结论超声造影可敏感、动态地观察甲状腺结节的增强特点,对伴有钙化的甲状腺结节的诊断具有较高的临床价值。

Objective To explore the clinical significance of contrast - enhanced ultrasound（CEUS）in diagnosis of calcified thyroid nodules. Methods Seventy three patients with benign thyroid nodules and 53 patients with malignant thyroid nodules were examined with two -dimensional ultrasound and CEUS respectively,and the constituent ratio of microcalcification,weak enhancement and inhomogeneous enhancement of benign and malignant nodules were compared,and time for beginning enhancement,duration to peak and peak intensity of benign and malignant nodules examined by CEUS were compared,and diagnostic value of CEUS and two - dimensional ultrasound in diagnosis of calcified thyroid nod-ules had been compared. Results The constituent ratio of microcalcification,weak enhancement and inhomogeneous enhancement of malignant nodules were higher than those of benign nodules（ P ﹤ 0. 05）. The peak strength of malignant nodules under CEUS was lower than that of benign nodules（ P ﹤ 0. 05）,there was no statistically significant difference in enhancement beginning time,time to peak of benign and malignant nodules （ P ﹥ 0. 05）. The sensitivity,specificity,positive predictive value and negative predictive value of CEUS in diagnosis of benign and malignant calcified thyroid nodules were higher than those of two - dimensional echocardiography（ P ﹤ 0. 05）. Conclusion CEUS has sensitive and dynam-ic characteristics in observation of thyroid nodules and it has a high clinical value in diagnosis of calcified thyroid nodules.