超声造影定量分析鉴别甲状腺结节良恶性价值

Value of contrast-enhanced ultrasound quantitative analysis in diagnosing benign or malignant thyroid nodules

目的探讨甲状腺结节实时超声造影增强特征定量分析与甲状腺结节良恶性的关系。方法对2014年4-8月于本院行手术切除且在术前行甲状腺结节超声造影检查的79例患者共计93个结节的超声造影动态图像进行分析,观察结节的增强特点,并将甲状腺结节实时超声造影图像进行时间-强度曲线分析,以周围甲状腺组织感兴趣区(region of interest,ROI)为基准,得出病灶内部ROI的相对达峰时间(RTTP)、相对峰强度(RPI)、相对平均通过时间(RMTT)及相对曲线下面积(RAUC)。结果恶性组病灶区RPI、RTTP、RMTT小于良性组病灶(P<0.05)。结节性甲状腺肿组病灶区RPI、RAUC小于甲状腺腺瘤组病灶区(P<0.05)。结论甲状腺结节实时超声造影增强特征定量分析对甲状腺结节良恶性的鉴别具有一定的临床意义,对于造影呈低增强且为快进快出的结节,应高度警惕,建议超声引导下穿刺活检以明确诊断。

Objective To explore the relationship between quantitative analysis in thyroid nodules detected by real-time contrast-enhanced ultrasound （CEUS） and characteristics of benign or malignant thyroid nodules.Methods Dynamic images detected by contrast-enhanced ultrasonography of 93 thyroid nodules from 79 patients who underwent surgery and contrast-enhanced ultrasonography before treatment in Chinese PLA General Hospital from April to August in 2014 were analyzed. The characteristics of enhancement and perfusion of thyroid nodules were observed. Thefilling intensity of both periphery and interior of the nodule was analyzed by time-intensity curve （TIC）. The surrounding thyroid tissue region of interest （ROI） was used as reference. The relative evaluated parameters of interior of the nodule within ROI, including relative peak time （RTTP）, relative peak intensity （RPI）, relative mean transit time （RMTT） and relative area under the curve （RAUC）, were observed.Results The RPI, RTTP, RMTT in malignant thyroid nodules were less than benign thyroid nodules, which showed statistical difference （P〈0.05）. RPI and RAUC in thyroid nodular goiter were less than thyroid adenoma, which also showed statistical difference （P〈0.05）.ConclusionQuantitative analysis of characteristics of thyroid nodule detected by real-time contrast-enhanced ultrasound has certain clinical significance in differentiation of benign and malignant thyroid nodules. The nodules that are fast forward quickly out and show low enhancement in angiography should be paid attention to check out whether it is malignant. Ultrasound guided puncturing is recommended to make a clear diagnosis.