超声造影联合定量分析技术在甲状腺良恶性结节诊断中的应用分析

Contrast-Enhanced Ultrasound Combined with Quantitative Analysis in the Diagnosis of Benign and Malignant Thyroid Nodules

目的:探讨超声造影联合定量分析技术在甲状腺良恶性结节诊断中的应用。方法:对2019年5月至2019年12月于我院进行超声造影检查的72例甲状腺结节患者的临床资料进行回顾性分析,观察甲状腺良恶性结节的超声造影增强模式特征,采用时间-强度曲线分析造影剂通过时间(MTT)、峰值强度(Peak)、达到峰值时间(TIP)及曲线下面积(AUC)等血流灌注参数,以术后病理结果作为对照,分析超声造影联合定量分析技术的诊断价值。结果:超声造影显示,72例甲状腺结节患者中,良性结节43个,恶性结节29个。良性结节的病理类型为甲状腺腺瘤和结节性甲状腺肿,其超声造影特征为内部均匀增强或无增强,周边环状增强,边界清晰;恶性结节病理类型均为甲状腺乳头状癌,其超声造影特征为低增强或不均匀增强,形态不规则,边界模糊等。经术后病理证实,良性结节47个,恶性结节25个。超声造影检查诊断甲状腺恶性结节的敏感度为88.00%,特异度为85.11%,准确率为86.21%。与甲状腺良性结节相比,甲状腺恶性结节的Peak及AUC较低,TIP较晚(P<0.05)。与甲状腺恶性结节周围正常组织相比,甲状腺恶性结节的Peak及AUC较低,TIP较晚(P<0.05)。与甲状腺良性结节周围正常组织比较,甲状腺良性结节的Peak及AUC略低,TIP略,MTT略慢,但均无显著差异(P>0.05)。结论:超声造影联合定量分析技术可用于甲状腺良恶性结节的鉴别诊断,定量参数Peak、AUC及TIP可反应甲状腺恶性结节的血管灌注规律。

Objective:To analyze the application of contrast-enhanced ultrasound combined with quantitative analysis in the diagnosis of benign and malignant thyroid nodules.Methods:Retrospective analysis was conducted of clinical data of 72 patients with thyroid nodules who underwent contrast-enhanced ultrasound examination in our hospital from May 2019 to December 2019.The characteristics of contrast-enhanced ultrasound enhancement mode of benign and malignant thyroid nodules were observed.The time-intensity curve was used to analyze blood flow perfusion parameters such as contrast medium transit time,peak intensity,peak time,and area under the curve.Using the postoperative pathological results as a control,the diagnostic value of contrast-enhanced ultrasound combined with quantitative analysis technology was analyzed.Results:Contrast-enhanced ultrasound showed that among 72 patients with thyroid nodules,43 were benign nodules and 29 were malignant nodules.The pathological types of benign nodules are thyroid adenomas and nodular goiters.Their contrast-enhanced ultrasound features are uniform enhancement or no enhancement inside,peripheral ring enhancement,and clear boundaries.The pathological types of malignant nodules are papillary thyroid carcinoma.Contrast-enhanced ultrasound is characterized by low or uneven enhancement,irregular morphology,and blurred borders.Postoperative pathology confirmed 47 benign nodules and 25 malignant nodules.The sensitivity of contrast-enhanced ultrasound in diagnosing malignant thyroid nodules was 88.00%,the specificity was 85.11%,and the accuracy was 86.21%.Compared with benign thyroid nodules,Peak and AUC in diagnosing malignant thyroid nodules were relatively lower,and had a later TIP(P<0.05).Compared with normal tissues surrounding thyroid malignant nodules,Peak and AUC of thyroid malignant nodules were lower and TIP was later(P<0.05).Compared with normal tissue around benign thyroid nodules,Peak and AUC of benign thyroid nodules were slightly lower,TIP was slightly later,and MTT was slightly slower,but there were no significant differences(P>0.05).Conclusion:Contrast-enhanced ultrasound combined with quantitative analysis technology can be used for the differential diagnosis of benign and malignant thyroid nodules,and the quantitative parameters Peak,AUC and TIP can reflect the vascular perfusion regularity of malignant thyroid nodules.