甲状腺微小乳头状癌与非微小癌超声造影特征比较

Comparison of contrast enhanced ultrasound features between papillary thyroid microcarcinoma and non-microcarcinoma

目的:对比分析甲状腺微小乳头状癌(PTC)与非微小癌超声造影特征差异。方法:回顾性分析2021年9月-2023年3月我院经手术或穿刺病理确诊的PTC患者96例(共101枚结节),按照肿瘤最大直径分成PTC组(最大直径≤10 mm)和非微小癌组(最大直径>10 mm),比较两组结节超声造影增强程度、增强方式、增强均匀性,分析两组超声造影定量参数的差异。结果:不同大小的PTC超声造影增强程度、增强方式、增强均匀性差异均存在统计学意义(P<0.05),PTC组向心性增强、等增强较非微小癌组多见,非微小癌组偏心性、弥漫性增强、低增强及高增强较PTC组多见。PTC组均匀性增强多见,非微小癌组不均匀性增强多见。两组超声造影定量参数上升时间(RT)、平均渡越时间(mTT)、下降时间(FT)差异有统计学意义(P<0.05),PTC组的RT、mTT、FT均高于非微小癌组,两组的达峰时间(TTP)、峰值强度(PE)、流入相比率(WiR)、流出相比率(WoR)、流入相灌注指数(WiPI)、流入相曲线下面积(WiAUC)、流出相曲线下面积(WoAUC)、流入相和流出相曲线下面积(WiWoAUC)差异无统计学意义。结论:PTC超声造影表现多以向心性、不均匀低增强为主,不同大小PTC具有不同的超声造影表现,临床诊断中需加以考虑。

Objective:To compare and analyze the differences in contrast enhanced ultrasound features between papillary thyroid microcarcinoma and non-microcarcinoma.Methods:A retrospective analysis was conducted on 96 patients(101 nodules)with papillary thyroid carcinoma diagnosed by surgery or puncture pathology at the People's Hospital of Guangxi Zhuang Au-tonomous Region from September 2021 to March 2023.They were divided into two groups based on the maximum diameter of the tumor:the papillary thyroid microcarcinoma group(maximum diameter≤10 mm)and the non-microcarcinoma group(maximum diameter>10 mm).The degree,mode and uniformity of contrast enhanced ultrasound enhancement were compared between the two groups.Analyze the differences in quantitative parameters between two groups of contrast enhanced ultrasound.Results:There were statistically significant differences in the qualitative signs(including enhancement degree,enhancement mode and enhancement uniformity)of thyroid papillary carcinoma of different sizes(P<0.05).The centripetal enhancement and isoenhance-ment were more common in the thyroid papillary microcarcinoma group than in the non-microcarcinoma group,while eccentric,diffuse enhancement,low enhancement and high enhancement were more common in the non-microcarcinoma group.Uniformity enhancement is more common in the papillary thyroid microcarcinoma group,while non-uniformity enhancement is more com-mon in the non-microcarcinoma group.As the nodules increase,eccentric and diffuse enhancement are more common.There was a statistically significant difference in the rise time(RT),mean transit time(mTT)and fall time(FT)of the quantitative pa-rameters of contrast enhanced ultrasound between the two groups.The time of RT,mTT and FT in thyroid papllary microcar-cinoma group was longer than that in non-microcarcinoma group.There was no statistically significant difference in the area under time to peak(TTP),peak enhancement(PE),wash-in rate(WiR),wash-out rate(WoR),wash-in perfusion index(WiPI),wash-in area under curve(WiAUC),wash-out AUC(WoAUC),wash-in and wash-out AUC(WiWoAUC)between the two groups.Conclusion:The contrast enhanced ultrasound manifestations of papillary thyroid carcinoma are mainly centripetal,uneven and low enhancement.Different sizes of papillary thyroid carcinoma have different contrast enhanced ultrasound manifestations.