超声造影成像特征及定量参数对甲状腺良恶性结节的诊断价值  

Diagnostic value of imaging characteristics and quantitative parameters of contrast-enhanced ultrasound in benign and malignant thyroid nnodules

作　　者：施燕芸[1] 李念芬[1] 张文[1] 孙红光[1] 戚庭月[1] 鞠萍[1] 程莲[1] 程红[1] 诸林海[1] 丁永玲[1] SHI Yan-yun;LI Nian-fen;ZHANG Wen(Department of Ultrasound,The Affiliated Hospital of Yangzhou Univertisy,Yangzhou Jiangsu 225012,China)

机构地区：[1]扬州大学附属医院超声科,江苏扬州225012

出　　处：《临床和实验医学杂志》2019年第2期201-205,共5页Journal of Clinical and Experimental Medicine

基　　金：扬州市科技计划社会发展面上项目(编号:YZ2017085)

摘　　要：目的探讨超声造影成像特征及定量参数对甲状腺良恶性结节的诊断价值。方法行手术切除的46例共63个甲状腺结节的超声造影资料。根据病理结果分为良性组和恶性组,回顾性分析良恶性结节微泡灌注特征及QLAB定量参数。结果造影成像特征中,显影时间、增强强度、均匀度、显影边界、消退时间在良恶性组之间有显著统计学差异(P <0. 05)。恶性组主要表现为迟显影、不均匀、低增强、显影边界不清晰及早消退;良性组主要表现为与周围甲状腺组织同时显影、同时消退、均匀等增强或高增强,及显影边界清晰。在造影后显示边缘环状结构的结节中,良性结节全部表现为规则高增强环,恶性结节大部分表现为不规则环,规则与不规则环状结构在良恶性结节之间有显著统计学差异(P <0. 05)。超声造影定量分析结果显示,恶性组峰值强度(PI)、曲线下面积(AUC)显著小于良性组,差异有统计学意义(P <0. 05),上升时间(RT)、达峰时间(TTP)良恶性组之间无统计学差异(P> 0. 05)。结论甲状腺良恶性结节超声造影具有不同的成像特征和定量参数,超声造影可为甲状腺良恶性结节的鉴别诊断提供更多信息。Objective To evaluate the imaging characteristics and quantitative parameters of contrast-enhanced ultrasound(CEUS)in the diagnosis of benign and malignant thyroid nodules.Methods Forty-six patients with sixty-three thyroid nodules underwent surgical resection were enrolled in this study.All patients performed CEUS preoperatively.Benign and malignant groups were identified according to the pathological findings.The microbubble perfusion characteristics and quantitative parameters of thyroid nodules analyzed by QLAB software were analyzed retrospectively.Results There was a significant difference between the benign and malignant groups in the aspect of wash-in,enhancement intensity,uniformity,boundary and wash-out of CEUS(P<0.05).In the malignant group,most of the nodules were characterized by wash-in later,inhomogeneous low-enhancement,blurred boundary and wash-out earlier.However,the imaging features of benign nodules were mainly in a similar time to surrounding thyroid parenchyma when wash-in and wash-out,homogeneous iso-enhancement or high-enhancement,and clear boundary.In the nodules showing Marginal ring structures,all benign nodules showed regular high-enhancement rings,and most of the malignant nodules showed irregular rings.There were significant differences between the benign and malignant nodules in regular and irregular ring structures(P<0.05).Quantitative analysis results demonstrated that the PI and AUC of malignant group were statistical significantly lower than those of benign ones(P<0.05),and there was no significant difference in RT and TTP between the benign and malignant nodules(P>0.05).Conclusion CEUS has different imaging features and quantitative parameters for benign and malignant thyroid nodules,and it is of high value in differentiation of thyroid nodules.

关 键 词：甲状腺结节 超声造影 成像特征 定量参数 鉴别诊断 

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] R736.1[医药卫生—临床医学]