超声造影结节大小变化在甲状腺微小乳头状癌诊断中的价值

The value of nodule size changes before and after contrast-enhanced ultrasound in the diagnosis of papillary thyroid microcarcinoma

目的:探讨甲状腺结节大小超声造影(contrast-enhanced ultrasound,CEUS)与灰阶超声测值差异在甲状腺微小乳头状癌(papillary thyroid microcarcinoma,PTMC)诊断中的价值。方法:回顾并分析346例经手术后病理学检查证实的甲状腺结节患者(414个甲状腺结节,最大径≤10 mm),其中PTMC 313个(PTMC组),良性病变101个(良性组),术前所有结节均行二维灰阶超声及CEUS检查,并分别测量结节的大小,统计分析PTMC组和良性组的灰阶超声与CEUS结节大小测值是否存在差异。结果:CEUS与灰阶超声结节大小测值比较,良性组差异无统计学意义(P>0.05),PTMC组差异有统计学意义(P<0.05);PTMC组结节大小的CEUS测值明显小于灰阶超声测值。结论:对于最大径≤10 mm甲状腺结节,结节大小的CEUS测值小于灰阶超声测值是PTMC的一项特征,利用结节大小的灰阶超声和CEUS测值差异可以进行结节良恶性的鉴别,该项指标的临床诊断价值值得进一步深入研究。

Objective:To investigate the value of the difference between the size of thyroid nodules measured by contrastenhanced ultrasound(CEUS)and gray-scale ultrasound in the diagnosis of papillary thyroid microcarcinoma(PTMC).Methods:Retrospectively analyzed 346 patients with thyroid nodules(414 thyroid nodules,maximum diameter≤10 mm)confirmed by pathological examination after surgery,including 313 PTMC(PTMC group),benign lesions 101(benign group).All nodules were conducted by the two-dimensional gray-scale ultrasound and CEUS examination,and measured the size of the nodule.Statistical analysis was conducted to determine whether there was any difference in the size of nodules measured by gray-scale ultrasound and CEUS between the PTMC group and the benign group.Results:Comparison of the size of nodules measured by contrast-enhanced ultrasound and gray-scale ultrasound,there was no statistical difference in the benign group(P>0.05),and there was statistical difference in the PTMC group(P<0.05);the nodule size measured by contrast-enhanced ultrasound in PTMC group was significantly smaller than that measured by gray-scale ultrasound.Conclusion:For the thyroid nodule with the maximum diameter≤10 mm,it is a characteristic of micropapillary carcinoma that the measured value of the nodule size by contrast-enhanced ultrasound is less than the measured value by gray-scale ultrasound.The difference between the measured value of the nodule size by gray-scale ultrasound and contrast-enhanced ultrasound can be used to identify the benign and malignant nodules.The clinical diagnostic value of this index is worth further study.