常规超声及超声造影参数对甲状腺乳头状癌被膜侵犯的评估  

The Evaluation of Conventional Ultrasound and Contrast Enhanced Ultrasound Parameters in Extrathyroidal Extension of Thyroid Papillary Carcinoma

作　　者：赵堃 崔秋丽[1] 严昆[1] 丁珂[1] 谢培凯 刘文英[1] Zhao Kun;Cui Qiuli;Yan Kun;Ding Ke;Xie Peikai;Liu Wenying(Department of Ultrasound,Key laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing),Peking University Cancer Hospital Institute,Beijing 100142,China;Department of Ultrasound,Zhuhai People's Hospital,Zhuhai,Guangdong 519000,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所超声科恶性肿瘤发病机制及转化研究教育部重点实验室,北京市100142 [2]珠海市人民医院超声影像科

出　　处：《中国超声医学杂志》2020年第1期4-7,共4页Chinese Journal of Ultrasound in Medicine

基　　金：首都卫生发展基金（No．首发2016-2-2153）

摘　　要：目的探讨常规超声及超声造影检查相关参数对评估甲状腺乳头状癌(PTC)被膜侵犯的应用价值。方法选取经手术病理证实的290例PTC患者共317个PTC结节,术前分别进行常规超声及超声造影定性定量检查,以病理结果癌结节有无被膜侵犯分组,回顾性比较常规超声及超声造影参数对判断被膜侵犯的价值。结果 317个癌结节中,经手术病理证实被膜侵犯为212个(66.88%),甲状腺癌结节大小、常规超声及超声造影条件下癌结节与被膜关系、结节动脉期灌注模式以及超声造影增强模式,在病理证实侵犯与未侵犯组之间差异具有统计学意义(P<0.05),多因素分析结果显示超声造影下癌结节与被膜接触、结节动脉期灌注模式表现为向心性增强以及超声造影表现为等增强及高增强与被膜侵犯相关(P<0.05)。结论常规超声检查及超声造影有助于判断甲状腺乳头状癌被膜是否侵犯,对临床应用具有一定的指导价值。Objective To explore the diagnostic value of conventional ultrasound(US)and contrast enhanced ultrasound(CEUS)parameters in extrathyroidal extension of papillary thyroid carcinoma(PTC).Methods 317 PTCs in 290 patients confirmed by surgery and pathology underwent conventional ultrasound and contrast enhanced ultrasound.Qualitative and quantitative analysis were done in two examinations.The PTC nodules were divided into negative group and positive group according to pathological diagnosis.The value of conventional ultrasound and contrast enhanced ultrasound in predicting extrathyroidal extension was retrospectively analyzed.Results There were 212 PTCs with extrathyroidal extension in 317 PTCs according to postoperative pathological diagnosis.There were statistically significant differences in nodules size,contact with thyroid capsule in US and CEUS,the arterial perfusion pattern and maximum intensity between two groups(P<0.05).In multivariate analysis,extrathyroidal extension was associated with contact with thyroid capsule observed in CEUS,centripetal enhancement and IMAX≥1(P<0.05).Conclusions Conventional ultrasound and contrast enhanced ultrasound could indicate the presence of extrathyroidal extension.

关 键 词：甲状腺乳头状癌 被膜侵犯 超声造影 常规超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]