常规超声联合超声造影鉴别诊断甲状腺恶性与炎性病灶

Conventional ultrasound combining with contrast-enhanced ultrasound for differential diagnosis of thyroid malignant and inflammatory lesions

目的观察常规超声联合超声造影(CEUS)鉴别诊断甲状腺恶性与炎性病灶的价值。方法纳入78例甲状腺疾病患者,根据病理结果将其分为恶性组(n=61)及炎性组(n=17);对比2组病灶常规超声及CEUS特点,并将组间差异有统计学意义的因素纳入回归分析,观察常规超声联合CEUS鉴别诊断甲状腺恶性与炎性病灶的价值。结果恶性组与炎性组病灶最大径、钙化情况、纵横比、造影剂到达时间、病灶增强模式及程度差异均有统计学意义(P均<0.05)。回归分析结果显示,病灶最大径<10 mm(OR=130.319,P<0.001)、慢进型增强(OR=6.177,P=0.013)、微钙化(OR=10.886,P=0.001)及向心性增强(OR=12.922,P<0.001)为甲状腺恶性病灶的预测因子,其曲线下面积分别为0.828[95%CI(0.740,0.916)]、0.703[95%CI(0.575,0.832)]、0.638[95%CI(0.501,0.775)]及0.630[95%CI(0.491,0.768)]。结论常规超声联合CEUS有助于鉴别诊断甲状腺恶性与炎性病灶;病灶伴微钙化、慢进型增强及向心性增强为恶性病灶的预测因子。

Objective To observe the value of conventional ultrasound combining with contrast-enhanced ultrasound(CEUS)for differential diagnosis of thyroid malignant and inflammatory lesions.Methods A total of 78 patients with thyroid lesions were enrolled and divided into malignant group(n=61)and inflammatory group(n=17)according to pathological results.Conventional ultrasound and CEUS characteristics of lesions were compared between groups,and the regression analysis was performed for parameters being statistically different between groups to observe the value of conventional ultrasound combining with CEUS for differential diagnosis of thyroid malignant and inflammatory lesions.Results There were significant differences of the maximum diameter,calcifications,the aspect ratios,the arrival time of contrast medium,as well as the enhancement modes and degrees of thyroid lesions between groups(all P<0.05).Regression analysis showed that the maximum diameter<10 mm(OR=130.319,P<0.001),slow progressive enhancement(OR=6.177,P=0.013),microcalcification(OR=10.886,P=0.001)and centripetal enhancement(OR=12.922,P<0.001)were predictors of thyroid malignant lesions,and the area under the curve was 0.828(95%CI[0.740,0.916]),0.703(95%CI[0.575,0.832]),0.638(95%CI[0.501,0.775])and 0.630(95%CI[0.491,0.768]),respectively.Conclusion Conventional ultrasound combining with CEUS was helpful for differential diagnosis of thyroid malignant and inflammatory lesions.The microcalcifications,slow progressive enhancement and centripetal enhancement were predictors of thyroid malignant lesions.