声触诊组织成像联合超声血管增强技术诊断低回声局灶性桥本甲状腺炎的价值

Application of virtual touch tissue imaging combined with ultrasound vascular enhancement technique in the diagnosis of hypoechoic focal Hashimoto thyroiditis

目的探讨声触诊组织成像(VTI)联合超声血管增强技术(VET)在低回声局灶性桥本甲状腺炎(FHT)诊断中的应用价值。方法回顾性分析经超声引导下细针穿刺抽吸术(FNA)或手术病理确诊的甲状腺低回声病灶52枚,其中FHT 20枚,甲状腺乳头状癌(PTC)32枚。观察病灶高频超声、VTI及VET特征,评估VTI联合VET对低回声FHT的诊断效能。结果95%(19/20)FHT病灶的VTI评分为1~3分,78%(25/32)PTC病灶VTI评分为4~5分,二者VTI评分比较差异有统计学意义(P<0.05)。VET显示FHT及PTC的血管形态及病灶内外甲状腺组织回声比较,差异有统计学意义(P<0.05)。VTI≤3分联合VET显示病灶内外甲状腺组织回声一致诊断FHT的敏感度、特异度、准确率分别为85.0%、93.8%、90.4%。结论VTI联合VET可有效鉴别低回声FHT及PTC,提高低回声FHT诊断准确率,具有较高的临床应用价值。

Objective To explore the application of virtual touch tissue imaging(VTI)combined with ultrasound vascular enhancement technique(VET)in the diagnosis of focal hypoechoic Hashimoto thyroiditis(FHT).Methods A total of 52 hypoechoic thyroid lesions,including 20 FHT cases and 32 papillary thyroid carcinoma(PTC)cases,which were diagnosed by ultrasound-guided fine needle aspiration(FNA)or surgical pathology were selected and their clinical data were retrospectively analyzed.The characteristics of the lesions were observed by high-frequency ultrasound,VTI and VET to evaluate the diagnostic efficacy of VTI combined with VET for hypoechoic FHT.Results The VTI score was 1 to 3 for 95%(19/20)FHT cases and 4 to 5 for 78%(25/32)PTC cases,which was statistically different(P<0.05).VET results showed that there were statistical differences between FHT and PTC in the vascular morphology and the echo of thyroid tissue within and outside the lesion(P<0.05).When VTI score≤3 combined with VET were used for diagnosis efficacy of the echo of thyroid tissue within and outside the lesion for FHT,the sensitivity,specificity,and accuracy was 85.0%,93.8%,and 90.4%,respectively.Conclusions VTI combined with VET can effectively distinguish hypoechoic FHT and PTC and improve the diagnostic accuracy of hypoechoic FHT,with high clinical application value.