超声造影定量参数与甲状腺乳头状癌腺外侵犯的相关性  

Correlation between contrast-enhanced ultrasound quantitative parameters and papillary thyroid carcinoma with extrathyroidal invasion

作　　者：倪恩珍[1] 张国梁[2] 张津[3] 张衡[1] 徐绯鞠 钱晓芹[3] 王娴[3] NI Enzhen;ZHANG Guoliang;ZHANG Jin;ZHANG Heng;XU Feiju;QIAN Xiaoqin;WANG Xian(Department of Radiology,the Affiliated Renmin Hospital,Jiangsu University,Jiangsu 212002,China)

机构地区：[1]江苏大学附属人民医院影像科,江苏省镇江市212002 [2]江苏大学附属人民医院普外科,江苏省镇江市212002 [3]江苏大学附属人民医院超声科,江苏省镇江市212002

出　　处：《临床超声医学杂志》2020年第11期812-815,共4页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金项目(81771848)。

摘　　要：目的探讨超声造影定量参数与甲状腺乳头状癌(PTC)腺外侵犯的相关性。方法回顾性分析我院经病理确诊的PTC患者112例(共157枚结节),其中甲状腺外侵犯60枚(ETE组),无甲状腺外侵犯97枚(无ETE组),比较两组结节大小、内部回声、边缘、血流信号、纵横径比,以及超声造影增强方式和增强强度;应用Logistic回归分析筛选PTC腺外侵犯影响因素;绘制定量分析参数峰值半降时间(TPH)、上升支斜率(WIS)和肿瘤最大径诊断PTC腺外侵犯的受试者工作特征(ROC)曲线,以约登指数最大为截断值,判断各参数诊断PTC腺外侵犯的敏感性、特异性。结果两组肿瘤最大径、超声造影定量参数WIS、上升时间(RT)、达峰时间(TTP)及TPH比较差异均有统计学意义(均P<0.05)。多元Logistic回归分析显示,肿瘤最大径、TPH及WIS是预测PTC腺外侵犯的独立影响因素(OR=4.135、0.907、16.721,均P<0.05);定量分析参数中以TPH诊断PTC腺外侵犯价值最大,其截断值为60.96时预测PTC腺外侵犯的敏感性、特异性分别为88.3%、60.8%,ROC曲线下面积为0.805。结论肿瘤最大径及超声造影定量参数TPH、WIS均与PTC腺外侵犯相关。ObjectiveTo investigate the correlation between contrast-enhanced ultrasound(CEUS)quantitativeparameters and papillary thyroid carcinoma(PTC)with extrathyroidal extension(ETE).MethodsRetrospective analysis of thepathological diagnosis in 112 patients with PTC(157 nodules)were performed,including 60 lesions with extrathyroidal extension(ETE group)and 97 lesions without extrathyroidal extension(no ETE group).The size,internal echo,size of the edge,blood flowsignal,ration of anteroposterior diameter to transverse diameter,CEUS enhancement pattern and intensity of the nodules betweentwo groups were compared.Then Logistic regression analysis was used to analyze risk factors for screening of PTC with ETE.ROCwas drawn to analyze the time from peak to one half(TPH),the wash in slope(WIS)and tumor maximum size in the diagnosis ofPTC with ETE.Taken maximum Youden index as cutoff value,the sensitivity,specificity of diagnosis of PTC with ETE weremeasured.ResultsTumor maximum size and the quantitative parameters of CEUS(WIS,RT,TTP,TPH)were significantlydifferent between the ETE group and no ETE group(all P<0.05).Multivariate Logistic regression analysis showed that tumormaximum size,TPH and WIS were independent risk factors in diagnosing PTC with ETE(OR=4.135,0.907,16.721,all P<0.05).Among the quantitative analysis parameters,TPH had the greatest value in diagnosing PTC with ETE.When cutoff value was60.96,the sensitivity and specificity were 88.3%and 60.8%,and area under the ROC curve was 0.805.ConclusionTumormaximum size,TPH and WIS are correlated with the PTC with ETE.

关 键 词：超声检查 造影剂 甲状腺肿瘤 甲状腺外侵犯 定量参数 

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]