超声造影成像对TI-RADS 4类甲状腺囊性皱缩结节诊断的临床应用

Clinical Application of Contrast-Enhanced Ultrasonography in the Diagnosis of TI-RADS Category 4 Cystic Shrunken Nodules

目的:探讨超声造影成像(CEUS)对TI-RADS 4类甲状腺囊性皱缩结节性质诊断效果.方法:选取2020年1月至2023年1月于本院就诊甲状腺结节患者中,被诊断为TI-RADS 4类甲状腺囊性皱缩结节的106例患者为研究对象,共112处病灶,纳入甲状腺囊性皱缩结节组(n=112).同期被同一家医院诊断的甲状腺乳头状癌(PTC)患者101例作为对照,共105处病灶,纳入PTC组(n=105).采取回顾性分析法比较两组病灶的超声表现及CEUS特点,分析CEUS特异性指标诊断甲状腺囊性皱缩结节的效能.结果:甲状腺囊性皱缩结节组与PTC组整体、壁增强模式的CEUS结果比较,差异有统计学意义(P<0.05);CEUS无增强模式诊断甲状腺囊性皱缩结节的灵敏度为95.11%,准确度为97.12%;壁增强模式诊断甲状腺囊性皱缩结节的灵敏度为55.26%,准确度为78.31%.结论:TI-RADS 4类甲状腺囊性皱缩结节超声表现与PTC存在一定相似度,但是CEUS鉴别诊断TI-RADS 4类甲状腺囊性皱缩结节可减少误诊,降低分类,避免不需要的手术和穿刺活检,值得临床广泛应用.

Objective:To explore the diagnostic effect of contrast-enhanced ultrasound imaging(CEUS)in TI-RADS category 4 thyroid cystic wrinkled nodules.Methods:A total of 106 patients diagnosed with TI-RADS category 4 cystic thyroid nodules who visited our hospital from January 2020 to January 2023 were selected as the study subjects,with a total of 112 lesions,and included in the group of cystic thyroid nodules(n=112),101 patients with papillary thyroid carcinoma(PTC)diagnosed by the same hospital during the same period served as controls,with a total of 105 lesions included in the PTC group(n=105).Retrospective analysis was used to compare the ultrasound appearance and CEUS characteristics of cystic shrunken thyroid nodules and PTC were compared,and the efficacy of CEUS-specific indicators in diagnosing thyroid cystic shrunken nodules was analyzed.Results:There were statistically significant differences in the CEUS results of overall and wall enhancement patterns between cystic shrunken thyroid nodules and PTC(P<0.05);the sensitivity and accuracy of CEUS non enhanced mode in diagnosing thyroid cystic wrinkled nodules are 95.11%and 97.12%,respectively;The sensitivity and accuracy of wall enhancement mode in diagnosing thyroid cystic wrinkled nodules are 55.26%and 78.31%,respectively.Conclusion:The ultrasound appearance of TI-RADS category 4 cystic shrunken nodules has a certain similarity with PTC;but the diagnosis of TI-RADS category 4 cystic shrunken nodules by CEUS can reduce misdiagnosis,reduce classification,avoid unnecessary surgery and needle biopsy,which is worthy of wideclinical application.