常规超声及超声造影对TI-RADS 4类甲状腺皱缩结节的诊断价值

Diagnostic value of conventional and contrast-enhanced ultrasound for thyroid shrinkage nodules of TI-RADS 4

目的:探讨常规超声及超声造影对TI-RADS 4类甲状腺皱缩结节的诊断价值。方法:选取行常规超声和超声造影检查的78例病人(80个诊断为TI-RADS 4类的结节),按照病理结果分为皱缩结节组38例(38个结节)和乳头状癌组40例(42个结节),行常规超声及超声造影检查,分别对常规超声声像图特点及超声造影的增强模式进行比较。结果:2组病人常规超声声像图表现在边界、回声、纵横比、钙化类型方面差异均无统计学意义(P>0.05),在钙化位置和“晕环征”方面差异有统计学意义(P<0.01),皱缩结节组钙化位置为边缘型、有晕环征、无增强或星点状低增强发生率均高于乳头状癌组(P<0.01)。甲状腺皱缩结节主要表现为无增强或点状低增强,乳头状癌主要表现为向心性低增强。结论:通过结节的钙化位置和有无“晕环征”的超声特点及超声造影的特征性表现可以区分甲状腺皱缩结节和乳头状癌,常规超声及超声造影对鉴别甲状腺皱缩结节和甲状腺乳头状癌有重要意义。

Objective:To investigate the diagnostic value of conventional ultrasound and contrast-enhanced ultrasound for TI-RADS 4 shrunken thyroid nodules.Methods:A tatal of 78 patients(80 nodules diagnosed as TI-RADS 4)undergoing conventional ultrasound and contrast enhanced ultrasound were selected and divided into the shrinkage nodule group(n=38,38 nodules)and the papillary carcinoma group(n=40,42 nodules)according to pathological results.Conventional ultrasound and contrast-enhanced ultrasound examinations were performed on all patients.The radiological characteristics of conventional ultrasound images and the enhancement modes of contrast-enhanced ultrasound were compared respectively.Results:In terms of conventional ultrasound image features,there was no statistical significance in boundary,echo,aspect ratio,and calcification type(P>0.05),but statistical significance was found in calcification location and"halo sign"(P<0.01)between the two groups.The incidence of marginal calcification,halo sign,no enhancement or low enhancement at stellate point in the shrinkage nodule group was higher than that in the papillary carcinoma group(P<0.01).Shrinkage nodules mainly showed no enhancement or punctate low enhancement,while papillary carcinoma mainly showed centripetal low enhancement.Conclusions:The position of calcification of the nodule,the presence or absence of"halo sign"and the characteristic manifestations of contrast-enhanced ultrasound can distinguish thyroid shrinkage nodules and papillary carcinoma.Conventional ultrasound and contrast-enhanced ultrasound are significant in distinguishing thyroid shrinkage nodules and thyroid papillary carcinoma.