超声造影定量参数在甲状腺良恶性结节鉴别诊断中的价值  

Values of the Quantitative Parameters of Contrast-enhanced Ultrasound in the Diagnosis of Thyroid Benign and Malignant Nodules

作　　者：马姣姣[1] 孙脉 田艳[1] 陈洁[1] 程靖宁[2] 王秀红[3] 张波[1] MA Jiaojiao;SUN Mai;TIAN Yan;CHEN Jie;CHENG Jingning;WANG Xiuhong;ZHANG Bo(Department of Ultrasound,,China-Japan Friendship Hospital,Beijing 100029,China;E.N.T.Department,,China-Japan Friendship Hospital,Beijing 100029,China;Department of Pathology,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院超声科,北京100029 [2]中日友好医院耳鼻咽喉头颈外科,北京100029 [3]中日友好医院病理科,北京100029

出　　处：《中国医学科学院学报》2020年第1期80-85,共6页Acta Academiae Medicinae Sinicae

基　　金：北京市卫生科技成果与适宜技术推广项目(2018-TG-39);北京市自然科学基金(7192152)~~

摘　　要：目的探讨超声造影定量参数和参数图在甲状腺良恶性结节鉴别诊断中的临床应用价值。方法对85个经手术病理证实甲状腺结节的超声造影表现进行定量分析,选取上升时间(RT)、达峰时间(TTP)、平均渡越时间(mTT)、峰值强度(Imax)及曲线下面积(AUC)5个定量参数和动态血管模型(DVP)曲线图描述其灌注特点,并进行统计分析。结果甲状腺恶性结节的Imax明显低于周围甲状腺组织(Z=-7.08,P=0.01),甲状腺良性结节的Imax明显高于周围甲状腺组织(Z=-1.35,P=0.02),良恶性结节间的Imax差异有统计学意义(Z=-4.16,P=0.00);甲状腺恶性结节的AUC明显小于周围甲状腺组织(Z=-2.03,P=0.04),甲状腺良性结节的AUC明显大于周围甲状腺组织(Z=-0.21,P=0.02),良恶性结节间的AUC差异有统计学意义(Z=-3.01,P=0.01)。RT(Z=-0.28,P=0.62)、TTP(Z=-0.10,P=0.89)和mTT(Z=-0.79,P=0.05)在甲状腺良恶性结节间的差异无统计学意义。甲状腺良恶性结节的DVP曲线图分型差异有统计学意义(P=0.00)。结论超声造影定量参数和参数图在甲状腺结节的诊断中有一定价值,Imax和AUC两项定量指标在甲状腺良恶性结节的鉴别诊断中价值显著。Objective To investigate the value of contrast-enhanced ultrasound(CEUS)quantitative parameters in the diagnosis of thyroid benign and malignant nodules.Methods The CEUS features of 85 histopathologically confirmed thyroid nodules were quantitatively analyzed using five parameters including rising time(RT),time to peak(TTP),area under the curve(AUC),maximum intensity(Imax),and mean transit time(mTT).The dynamic vascular pattern(DVP)curves were also drawn.Results The Imax(Z=-7.08,P=0.01)and AUC(Z=-2.03,P=0.04)of thyroid malignant nodules were significantly smaller than those of thyroid tissue,and the Imax(Z=-1.35,P=0.02)and AUC(Z=-0.21,P=0.02)of thyroid benign nodules were significantly larger than those of thyroid tissue.There were significant differences between thyroid benign and malignant nodules in Imax(Z=-4.16,P=0.00),AUC(Z=-3.01,P=0.01),and DVP curve types(P=0.00).RT(Z=-0.28,P=0.62),TTP(Z=-0.10,P=0.89),and mTT(Z=-0.79,P=0.05)were not significantly different between thyroid benign and malignant nodules.Conclusion The quantitative parameters of CEUS,especially Imax and AUC parameters,are valuable in the diagnosis of benign and malignant thyroid nodules.

关 键 词：甲状腺 超声造影 定量参数 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]