超声造影对桥本甲状腺炎合并甲状腺结节的诊断价值

Diagnostic Value of Contrast-enhanced Ultrasound of Thyroid Nodules Coexisting with Hashimoto's Thyroiditis

目的评价桥本甲状腺炎(HT)背景下超声造影(CEUS)对甲状腺结节的诊断价值。方法回顾性分析了48例HT患者共62个结节的CEUS特征,计算增强模式及增强程度对HT背景下甲状腺恶性结节的诊断价值。结果增强程度(P=0.002)和增强模式(P<0.001)在HT背景下甲状腺良、恶性结节组间差异有统计学意义。不均匀增强诊断HT背景下甲状腺恶性结节的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为97.6%、85.7%、93.0%、94.7%和93.5%。低增强诊断HT背景下甲状腺恶性结节的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为85.4%、52.4%、77.8%、64.7%和74.2%。结论不均匀增强对于HT背景下甲状腺恶性结节具有较好的诊断价值。对于常规超声诊断困难的甲状腺结节,CEUS可以提高诊断的准确性。

Objective To evaluate the value of contrast-enhanced ultrasound（ CEUS） in diagnosing thyroid nodules coexisting with Hashimoto＇s thyroiditis（ HT）. Methods Totally 62 thyroid nodules in 48 HT patients were retrospectively analyzed. The CEUS characteristics were reviewed,and diagnostic value of enhancement pattern and peak intensity were calculated. Results Peak intensity（ P = 0. 002） and enhancement pattern（ P 0. 001） differed significantly between malignant and benign thyroid nodules. The sensitivity,specificity,positive predictive value（ PPV）,negative predictive value（ NPV）,and accuracy of heterogeneous enhancement were 97. 6%,85. 7%,93. 0%,94. 7%, and 93. 5%, respectively. Sensitivity, specificity, PPV,NPV and accuracy of low intensity at peak time were 85. 4%,52. 4%,77. 8%,64. 7%,and 74. 2%,respectively. Conclusions Heterogeneous enhancement is effective in the diagnosis of malignant thyroid nodules coexisting with HT. CEUS can improve the diagnostic accuracy in distinguishing thyroid nodules with unknown malignancy under the conventional ultrasound.