超声造影对桥本氏甲状腺炎背景下良恶性结节的诊断价值

Value of contrast-enhanced ultrasonography in the differential diagnosis of thyroid nodules under the background of Hashimoto's thyroiditis

目的:探讨超声造影(CEUS)对桥本氏甲状腺炎(HT)背景下甲状腺结节的诊断价值。方法:对78例(101个)经手术病理证实的桥本氏甲状腺炎背景下甲状腺结节的超声造影,采用TomTec软件进行量化分析,获得造影参数:始增时间、达峰时间和最大峰值强度,比较良性组与恶性组之间的差异。结果:HT背景下101个结节中,良性63个,恶性38个。恶性结节的超声造影增强特征以不均匀增强、低增强为主,良性结节以环状增强、均匀增强、等增强多见。超声造影参数恶性组与良性组始增时间(AT)、达峰时间(TTP)差异无统计学意义(P>0.05),峰值强度(IMAX)的差异有统计学意义(P<0.05)。CEUS诊断HT背景下甲状腺结节的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为92.1%、95.2%、92.1%、95.2%、94.1%。结论:超声造影可以提高桥本氏甲状腺炎背景下甲状腺结节的诊断准确性。

Objective： To evaluate the value of the differential diagnosis of thyroid nodules under the background of Hashimoto ＇s thyroiditis（ HT） using contrast-enhanced ultrasonography（ CEUS）. Methods： Totally 101 thyroid nodules in 78 HT patients confirmed by operations and pathology were given CEUS examination. The parameters as follows： Rise time（ RT）,time to peak（ TTP）,and maximum intensity（ IMAX） were compared by using Tom Tec analysis software. Results： In 101 nodules,there were 63 benign thyroid nodules,and 38 malignant thyroid nodules. Most malignant nodules showed inhomogeneous enhancement and hypo-enhancement,while most benign nodules showed circular enhancement,homogeneous enhancement and homo-enhancement. There were no significant differences in RT or TTP between the two groups,while IMAX was higher in benign nodules than those in malignant nodules（ P〈0.05）. The sensitivity,specificity,positive predictive value（ PPV）,negative predictive value（ NPV）,and accuracy of CEUS in diagnosis of benign and malignant thyroid nodules with HT were 92. 1%,95. 2%,92. 1%,95. 2%,and 94. 1%. Conclusion： CEUS can improve the diagnostic accuracy in the distinguishing thyroid nodules under the background of HT.