二维超声联合CEUS鉴别诊断良恶性甲状腺结节

Two-dimensional ultrasound combined with CEUS in differential diagnosis of benign and malignant thyroid nodules

目的探讨二维超声联合CEUS对良恶性甲状腺结节的鉴别诊断价值。方法对94例甲状腺结节患者(共99个结节)行常规超声、CEUS检查,观察甲状腺结节的二维超声、CEUS特征。分析比较良、恶性甲状腺病变超声特征的差异。对存在统计学意义的观察指标进行赋值后、比较各分值的鉴别诊断效能。结果 99个甲状腺结节中,30个为恶性结节,69个为良性结节。良、恶性病灶二维声像图特征中,回声、纵横比、形态、边界、钙化、回声均匀度的差异均有统计学意义(P均<0.05);CEUS特征中,相对始入时间、环状增强、后期低增强的差异均有统计学意义(P均<0.05)。二维超声与CEUS参数的总评分≥4分时,可获得较好的敏感度及特异度、分别为86.67%(26/30)、78.26%(54/69)。结论二维超声联合CEUS是鉴别诊断甲状腺结节良、恶性的一种可行、有效的方法。

Objective To explore the value of two dimensional ultrasound combined with CEUS in differential diagnosis of benign and malignant thyroid nodules.Methods Totally 94 patients with 99 thyroid nodules underwent conventional ultrasound and CEUS,and then the characteristics of thyroid nodules were observed,and the differences were statistically analyzed between benign and malignant lesions.The statistically significant measures were assigned.And then the effectiveness of each score in differential diagnosis of benign and malignant thyroid nodules were compared.Results In 99 nodules,30of them were malignant（malignant group）,69 of them were benign（benign group）.The characteristics of two-dimensional ultrasound,including echo performance,aspect ratio,shape,border,calcification and uniformity of the echogenicity were significantly different between benign group and malignant group.The characteristics of CEUS,including the relative beginning time of nodule enhancement,ring-enhancement and hypoechoic enhancement in late phase were significantly different between benign group and malignant group.The score of parameters by two dimensional ultrasound and CEUS ≥4can achieve better sensitivity（26/30,86.67%）and specificity（54/69,78.26%）in differential diagnosis of benign and malignant nodules.Conclusion Two dimensional ultrasound combined with CEUS would be a feasible and effective method in differential diagnosis benign and malignant nodules.