CEUS定性及定量诊断甲状腺结节

Qualitative and quantitative diagnosis of CEUS in thyroid nodules

目的探讨CEUS目测定性法与时间-强度曲线(TIC)定量法诊断甲状腺结节良恶性的临床价值。方法对81例94个取得病理诊断结果的甲状腺实性结节术前行CEUS,分别采用定性法、定量法观察各指标,进行单因素分析后采用Logistics回归行多因素分析;采用ROC曲线比较定性法及定量法。结果定性法中动脉期增强程度、增强时相、实质期增强程度及环形强化诊断甲状腺良恶性结节差异有统计学意义(P<0.05);定量法中,始增时间、相对始增时间(rRT)、峰值强度(IMAX%)、峰值时间、相对峰值时间诊断甲状腺良恶性结节差异有统计学意义。定性法动脉期增强程度对鉴别良恶性结节差异有统计学意义(P<0.001)。定量法中,IMAX%(P=0.006)和rRT(P=0.004)对鉴别结节良恶性差异有统计学意义。定性法及定量法诊断甲状腺恶性结节准确率分别为73.40%(69/94)和79.79%(75/94)。定性法和定量法ROC曲线下面积分别为0.756和0.868(P=0.002)。结论甲状腺结节CEUS TIC定量法诊断能力优于定性法。定量法中甲状腺结节增强IMAX%减低和rRT增加对诊断恶性结节最有意义。

Objective To explore the qualitative and quantitative analysis value of CEUS in identification of benign and malignant thyroid nodules. Methods A total of 94 thyroid nodules in 81 patients with definitive tissue diagnosis were included. Qualitative and quantitative indicators of CEUS for thyroid nodules were retrospectively analyzed. Logistic regression was applied and ROC curves were drawn for evaluation and comparison. Results Qualitative analysis showed four significant qualitative factors, namely degree of enhancement in artery phase, enhancement phase, degree of enhancement in parenchymal phase and ring enhancement. Time-intensity curve （TIC） analysis showed five significant quantitative factors, namely rise time, relative rise time （rRT）, IMAX%, peak time and relative peak time. Degree of enhancement was significant qualitative factor in differentiating benign and malignant nodules, which accuracy was 73.40M （69/94）. IMAX% and rRT were significant quantitative factors in differentiating benign and malignant nodules, which accuracy was 79.79 % （75/ 94）. The area under the ROC curve for quantitative and qualitative analysis were 0. 756 and 0. 868 （P=0. 002）. Conclusion The ability of CEUS quantiative analysis is better in predicting benign and malignant thyroid nodules than that of qualitative analysis. IMAX% reduction and rRT increasing are most valuable in diagnosis of malignant thyroid nodules.