常规超声及超声造影对甲状腺囊性乳头状癌的诊断价值

Diagnostic Value of Conventional Ultrasound and Contrast-Enhanced Ultrasound in Cystic Papillary Thyroid Carcinoma

目的:探究常规超声及超声造影(contrast-enhanced ultrasonography,CEUS)对甲状腺囊性乳头状癌(囊性亚型)的诊断价值。方法:回顾69例囊性亚型及300例甲状腺经典型乳头状癌(经典亚型)的常规超声、CEUS特征,并对时间-强度曲线(time-intensity curve,TIC)定量参数进行分析。结果:囊性亚型与经典亚型的最大径、边界、形态、纵横比、实性成分回声、钙化灶、Adler血流分级、CEUS微血管灌注特征的差异有统计学意义(P<0.05)。TIC参数峰值强度(peak intensity,PI)、曲线下面积(area under the curve,AUC)和上升斜率(wash in slope,WIS)的差异无统计学意义(P>0.05),参数达峰时间(time to peak,TTP)、上升时间(rise time,RT)、峰值强度减半时间(time from peak to one half,TPH)和造影剂平均渡越时间(mean transit time,MTT)的差异有统计学意义(P<0.05)。结论:在常规超声的基础上,结合CEUS的灌注特征和TIC定量参数,可以为甲状腺囊性乳头状癌的诊断提供更多有价值的信息。

Objective: To investigate the diagnostic value of conventional ultrasound and contrast-enhanced ultrasound(CEUS) in cystic papillary thyroid carcinoma(cystic subtype). Methods: Features of conventional ultrasound and CEUS in 69 cases of cystic subtype and 300 cases of classic papillary thyroid carcinoma(classic subtype) were reviewed, and time-intensity curve(TIC) quantitative parameters were analyzed. Results: There were statistically significant differences between the cystic subtype and the classic subtype group in maximum diameter, boundary, shape, aspect ratio, parenchymal echogenicity, calcified lesions, Adler blood flow classification and CEUS microvascular perfusion characteristics(P<0.05). There were no significant differences in time to peak, rise time, time from peak to one half and mean transit time(P>0.05), and differences in peak intensity, area under the curve and wash in slope were statistically significant(P<0.05). Conclusion: Conventional ultrasound combined with CEUS perfusion characteristics and TIC quantitative parameters can provide more valuable information for the diagnosis of cystic papillary thyroid carcinoma.