超声造影对判断甲状腺良恶性结节的诊断价值

An investigation on the feasibility of using real-time contrast-enhance ultrasound for differentiating the benign and malignant thyroid nodules

目的探讨实时超声造影(CEUS)对判断甲状腺良恶性结节诊断的价值。方法选择常规超声检测的88例患者124个甲状腺实性结节,采用实时超声造影技术,观察甲状腺结节的超声造影模式。所有病例均在手术或细针抽吸活检前进行检查,并经病理结果证实。结果 124个甲状腺结节,恶性结节56个,均为乳头状癌;良性结节68个,其中结节性甲状腺肿62个,腺瘤2个,肉芽肿性甲状腺炎2个,甲状腺炎2个。超声造影表现低增强、等增强和高增强三种模式。本组恶性结节均为乳头状癌,主要呈现低增强(46/56),良性结节以结节性甲状腺肿为多(62/68),等增强为主(52/62)。甲状腺良恶性结节在超声造影结果比较差异有统计学意义(P= 0.000)。结论超声造影能够为甲状腺良恶性结节判断提供更多的诊断信息。

Objective To investigate the feasibility of using real-time contrast-enhance ultrasound（CEUS）in differentiating benign and malignant thyroid nodules.Mathods 124 thyroid solid nodules from 88 patients were scanned with CEUS,the enhancement characteristic was analyzed before fine needle aspirates（FNA）or surgery.All cases were confirmed with histopathologic examination.Results In 124 nodules,56 were malignant and 68 were benign.The 56 malignant nodules were all papillary carcinoma.The 68 benign nodules included 62 nodular goiters,2 adenomas,2 granulomas and 2 Hashimoto′s thyroid.After administration of Sono Vue,three enhancement patterns（hypoenhancement isoenhancement and hyperenhancement）were identified.In this study,malignant nodules were all papillary carcinomas and most of them showed hypoenhanced pattern（46/56）most of the benign nodules were nodular goiters（62/68）and showed isoenhanced pattern（52/62）There was significant difference in enhancement patterns between benign and malignant nodules,P = 0.000.Conclusion CEUS provides useful information in differentiating benign and malignant thyroid nodules.