不同被膜接触关系下常规超声与超声造影对甲状腺乳头状癌被膜侵犯的诊断价值

Diagnostic value of conventional ultrasound and contrast-enhanced ultrasound in capsule invasion of papillary thyroid carcinoma

目的 探讨不同被膜接触关系下常规超声(conventional ultrasound, CUS)与超声造影(contrast-enhanced ultrasound, CEUS)对甲状腺乳头状癌(papillary thyroid cancer, PTC)被膜侵犯的诊断价值。方法 选取104例经手术病理证实为单发甲状腺乳头状癌结节患者(104个癌结节),分析104个癌结节甲状腺被膜接触位置、接触面积与被膜侵犯的相关性,比较CUS、CEUS对PTC被膜侵犯的诊断效能。结果 104个癌结节中49个未发生被膜侵犯,55个发生被膜侵犯。结节与前被膜接触发生被膜侵犯的概率显著低于前后被膜,差异有统计学意义(P<0.05);与被膜接触面积≤25%发生被膜侵犯的概率显著低于接触面积为25%~50%及接触面积≥50%的,差异有统计学意义(P<0.05)。CEUS诊断被膜侵犯的敏感度显著高于CUS(76.36%&58.18%)。当接触面积≤25%时CEUS诊断被膜侵犯的敏感度显著高于CUS(64.29%&21.43%)。结论 CUS及CEUS对PTC被膜侵犯的诊断有一定的临床价值,但CEUS的敏感度要优于CUS,尤其是在与被膜接触面积≤25%时。

Objective To investigate the diagnostic value of conventional ultrasound(CUS)and contrast-enhanced ultrasound(CEUS)for capsule invasion of papillary thyroid carcinoma under different capsule contact relationships.Methods The correlations between thyroid capsule contact position,contact area and capsule invasion in 104 cancer nodules were analyzed.The diagnostic efficacy of CUS and CEUS in diagnosing capsule invasion was compared.Results Of the 104 cancer nodules,49 did not have capsule invasion,and 55 had capsule invasion.The invasion incidence of anterior capsule contact was lower than those of posterior and anterior capsule contact(P<0.05).The invasion incidence of contact area≤25%was lower than those of 25%~50%and≥50%(P<0.05).The sensitivity of CEUS was significantly higher than that of CUS(76.36%&58.18%),however,the accuracy was similar(P=0.192).When the contact area was≤25%,the sensitivity of CEUS was significantly higher than that of CUS(64.29%&21.43%).Conclusion Both CUS and CEUS were helpful in the diagnosis of PTC capsule invasion,but the sensitivity of CEUS was better than that of CUS,especially when the contact area of the capsule was≤25%.