超声造影诊断甲状腺癌的临床价值

Clinical value of contrast-enhanced ultrasonography in diagnosing thyroid carcinoma

目的探讨超声造影诊断甲状腺癌的临床价值。方法对2014年1月~2015年8月在上海新华医院行甲状腺超声造影的129例甲状腺结节患者的临床资料进行分析,比较超声造影与病理结果,总结其影像学特征。结果 129例中共有甲状腺结节132枚,超声造影诊断为甲状腺癌103枚、良性结节24枚、甲状腺炎5枚。与病理结果比较,超声造影诊断准确度88.6%,灵敏度92.2%,特异度75.9%。31例诊断不符合,8例甲状腺癌误诊为良性结节,3例甲状腺炎误诊为甲状腺癌,20例结节性甲状腺肿误诊为甲状腺癌。恶性结节以乳头状癌居多,在超声造影中以"低增强"与"慢进快出"为特征表现。结论超声造影对甲状腺癌的诊断具有较理想的特异性和灵敏性,"低增强"与"慢进快出"征象为甲状腺癌的重要影像特征。

OBJECTIVE To evaluate the clinical value of contrast-enhanced ultrasonography （CEUS） in diagnosing thyroid carcinoma. METHODS The clinical data of 129 patients with thyroid nodules, who were examined by CEUS and were operated in Xinhua Hospital between Jan 2014 and Aug 2015, were analyzed in order to compare the diagnostic results of CEUS to the postoperative pathologic findings, and to summarize its imaging features. RESULTS A total of 132 thyroid nodules in 129 patients were examined by CEUS. Among them, 103 nodules were diagnosed as thyroid carcinoma, 24 nodules were benign thyroid tumor and 5 nodules were thyroiditis. Compared with pathology results, the diagnostic accuracy, sensitivity and specificity of contrast-enhanced ultrasound is 88.6%, 92.2% and of 75~9% respectively. The diagnosis of the CEUS in 31 cases was not consistent with the pathological results, in which 8 cases of thyroid carcinoma were misdiagnosed as benign tumor, 3 cases of thyroiditis were misdiagnosed as thyroid carcinoma, and 20 cases of benign tumors were misdiagnosed as thyroid carcinoma. The malignant thyroid nodules mainly were papillary carcinoma, which was characterized by ＇low enhanced＇ and ＇slow in fast out＇ performance in the contrast-enhanced ultrasound examination. CONCLUSION The contrast-enhanced ultrasound examination in diagnosing thyroid carcinoma has much more specificity and sensitivity, the ＇low-enhanced＇ and ＇slow in fast out＇ signs of the CEUS were the important features of malignant thyroid nodules.