实时灰阶超声造影在良恶性甲状腺结节诊断中的临床应用研究  

Clinic application of the contrast - enhanced ultrasound mode in differential diagnosis of thyroid nodules

作　　者：张椰 张连仲[1] 段少博[1] 徐爽[1] 苏自杰 

机构地区：[1]郑州大学人民医院特需中心,450003

出　　处：《中国实用医刊》2017年第6期84-86,共3页Chinese Journal of Practical Medicine

基　　金：河南省科技厅重点攻关项目（162102310177）

摘　　要：目的探讨实时灰阶超声造影不同增强特征在甲状腺良实性结节诊断及鉴别诊断．中的临床应用价值。方法收集2015年6月至2016年6月拟行手术切除的甲状腺结节患者38例，共46枚结节，行常规超声及超声造影检查。实时观察记录结节常规超声特征及造影增强模式，所有结节性质均经术后常规病理证实。结果46枚甲状腺结节均经手术病理证实，30枚证实为恶性结节，16枚证实为良性结节。46枚结节超声造影表现多种模式，有低增强、等增强及高增强，其中恶性结节以乳头状癌为主（28／30），主要呈现不均匀低增强（23／30）；良性结节以结节性甲状腺肿为主（9／16），主要呈均匀等增强及高增强（14／16）。两组结节超声造影结果比较差异有统计学意义（P〈0．05）；超声造影诊断恶甲状腺性结节的灵敏度、特异度、准确率分别为90．0％（27／30）、68．8％（11／16）、82．6％（38／46）。结论良恶性甲状腺结节在超声造影增强模式上存在一定差异，超声造影能够用于对甲状腺良恶性结节的诊断。Objective To investigate the feasibility of contrast - enhanced ultrasound（CEUS） in the diagnosis and differential diagnosis of benign and malignant thyroid nodules. Methods From June 2015 to June 2016, 38 patients contained 46 of thyroid nodules underwent routine ultrasound and contrast -enhanced ultrasound. The characteristics of thyroid nodule were timely recorded by routine ultrasound and CEUS, respectively. All thyroid nodules were compared with postoperative histopathological results as the standard of reference. Results The 46 thyroid nodules were confirmed by histopathological examination, among them 30 thyroid nodules demonstrated malignant nodules, and 16 were benign nodules. Three enhancement patterns were depicted by the CEUS, containing low -enhancement, iso -enhancement and hyper- enhancement. The malignant thyroid nodules mainly consisted of papillary thyroid carcinoma （PTC） （28/30） , which were demonstrated heterogeneous low - enhancement （23/30） on the CEUS. The benign thyroid nodules mainly consisted of nodular goiter （9/16） , which were demonstrated iso -enhancement and hyperenhancement （14/16） on the CEUS. The results of two groups of nodules were compared, the differences were significant （ P 〈 0.05 ）. The sensitivity, specificity and accuracy of CEUS in the diagnosis of thyroid malignant nodules was 90.0% （27/30）, 68.8% （11/16）, 82.6% （38/46）. Conclusions There is certain difference between benign and malignant thyroid nodules in contrast- enhanced ultrasound. CEUS can be used to make the differential diagnosis malignant thyroid nodules from benign thyroid nodules.

关 键 词：甲状腺结节 超声造影 增强模式 

分 类 号：R445.1[医药卫生—影像医学与核医学] R581[医药卫生—诊断学]