超声造影定量分析参数水平在甲状腺结节性质鉴别诊断中的价值

Value of quantitative analysis parameters of contrast-enhanced ultrasound in diagnosis of thyroid nodules

目的:分析超声造影(CEUS)定量分析参数水平在甲状腺结节性质鉴别诊断中的价值。方法:回顾性分析2020年2月至2022年2月该院收治的124例甲状腺结节患者的临床资料,所有患者均给予CEUS检查,以病理学检查结果为“金标准”,比较不同性质甲状腺结节、不同病理学特征甲状腺恶性结节患者CEUS检查参数[造影剂通过时间(MTT)、峰值强度(Peak)、达峰时间(TIP)]水平,采用Spearman相关性分析CEUS定量分析参数水平与不同病理学特征甲状腺恶性结节的相关性。结果:病理学检查结果显示,124例甲状腺结节患者中,良性58例,恶性66例;不同性质甲状腺结节与周围正常组织MTT水平比较,差异均无统计学意义(P>0.05);恶性结节、良性结节Peak水平低于周围正常组织,且恶性结节低于良性结节;恶性结节、良性结节TIP水平高于周围正常组织,且恶性结节高于良性结节,差异有统计学意义(P<0.05);不同病理学特征甲状腺恶性结节MTT水平比较,差异均无统计学意义(P>0.05);不同病理学特征甲状腺恶性结节Peak水平比较,淋巴结转移的低于淋巴结未转移,临床分期Ⅲ~Ⅳ期的低于Ⅰ~Ⅱ期,浸润深度T_(3)~T_(4)的低于T_(1)~T_(2);不同病理学特征甲状腺恶性结节TIP水平比较,淋巴结转移的高于淋巴结未转移,临床分期Ⅲ~Ⅳ期的高于Ⅰ~Ⅱ期,浸润深度T_(3)~T_(4)的高于T_(1)~T_(2),差异有统计学意义(P<0.05);经Spearman相关性分析结果显示,Peak水平与淋巴结转移、临床分期、浸润深度均呈负相关(r<0,P<0.05),TIP水平与淋巴结转移、临床分期、浸润深度均呈正相关(r>0,P<0.05)。结论:CEUS定量分析参数水平可应用于甲状腺结节的性质诊断和病情评估。

Objective:To analyzed value of quantitative analysis parameters of contrast-enhanced ultrasound(CEUS)in diagnosis of thyroid nodules.Methods:The clinical data of 124 patients with thyroid nodules admitted to this hospital from February 2020 to February 2022 were retrospectively analyzed.All patients were given CEUS examination.Using the pathological examination results as the“gold standard”,the CEUS examination parameters[contrast agent transit time(MTT),peak intensity(Peak),time to peak(TIP)]levels of the patients with different types of thyroid nodules and different pathological features of thyroid malignant nodules were compared.Spearman correlation analysis was used to analyze the correlations among the CEUS quantitative analysis parameter levels and the malignant thyroid nodules with different pathological features.Results:The pathological examination showed that among the 124 patients with thyroid nodules,58 were benign and 66 were malignant.There was no significant difference in the MTT level among different thyroid nodules and surrounding normal tissues(P>0.05).The Peak level of the malignant nodules was lower than those of the benign nodules and the surrounding normal tissues,and that of the benign nodules was lower than that of the surrounding normal tissues;the TIP level of the malignant nodules was higher than those of the benign nodules and the surrounding normal tissues,and that of benign nodules was higher than that of surrounding normal tissues;and the differences were statistically significant(P<0.05).There was no statistically significant difference in the MTT level among the thyroid malignant nodules with different pathological features(P>0.05).The comparison of the Peak levels of the malignant thyroid nodules with different pathological features showed that that of the nodules with lymph node metastasis was lower than those without lymph node non-metastasis,that of those with clinical stage Ⅲ-Ⅳ was lower than that of those with stage Ⅰ-Ⅱ,and that of those with depth of invasion T_(3)-T_(4) was lower than that of those with T_(1)-T_(2);the comparison of the TIP levels in the thyroid malignant nodules with different pathological features showed that that of nodules with the lymph node metastasis was higher than that of those with without lymph node metastasis,that of those with clinical stage Ⅲ-Ⅳ was higher than that of those with stage Ⅰ-Ⅱ,and that of those with infiltration depth T_(3)-T_(4) was higher than that of those with T_(1)-T_(2);and the differences were statistically significant(P<0.05).Spearman correlation analysis showed that the Peak level was negatively correlated with lymph node metastasis,clinical stage and depth of invasion(r<0,P<0.05),and the TIP level was positively correlated with lymph node metastasis,clinical stage and depth of invasion(r>0,P<0.05).Conclusions:CEUS quantitative analysis parameter levels can be applied to the diagnosis and evaluation of thyroid nodules.