超声造影在甲状腺良恶性实性结节鉴别诊断中的应用研究  

Application of Contrast-enhanced Ultrasound in the Differential Diagnosis of Benign and Malignant Thyroid Nodules

作　　者：林联合[1] 叶真[1] 陈竞函 LIN Lian-he;YE Zhen;CHEN Jing-han(Department of Ultrasound Imaging,the First Affiliated Hospital of Fujian Medical University,Fuzhou,Fujian Province,350005 China;Department of Oral and Maxillofacial Surgery,the First Affiliated Hospital of Fujian Medical University,Fuzhou,Fujian Province,350005 China)

机构地区：[1]福建医科大学附属第一医院超声影像科,福建福州350005 [2]福建医科大学附属第一医院口腔颌面外科,福建福州350005

出　　处：《中外医疗》2020年第34期174-177,共4页China & Foreign Medical Treatment

摘　　要：目的通过对TI-RADS分类为3类及3类以上甲状腺实性结节行超声造影(contrast enhanced ultrasound,CEUS)检查,探讨甲状腺良恶性实性结节CEUS的声像特征及CEUS在甲状腺良恶性实性结节鉴别诊断中的应用价值。方法使用声诺维造影剂及配备L12-5线阵探头的PHILIPS IU ELITE超声诊断仪对方便选取的2014年12月—2016年3月期间福建医科大学附属第一医院超声影像科常规高频超声检查发现的53例患者63个甲状腺实性结节(TI-RADS分类3类及3类以上)行CEUS,观察增强情况。结果①甲状腺乳头状癌超声造影典型声像有:梯度增强,低增强,不均匀增强,晚增强,早廓清,边界不清,边缘不规则。②常规高频超声诊断正确率79.37%,超声造影诊断正确率85.71%,常规高频超声+超声造影诊断正确率93.65%。结论实性的甲状腺乳头状癌、结节性甲状腺肿及甲状腺腺瘤各有其超声造影声像特征。超声造影与常规高频超声的联合应用诊断正确率高于常规高频超声。Objective To examine the CEUS(Contrast Enhanced Ultrasound)examination of TI-RADS classification 3 and above solid thyroid nodules,and to explore the application value of CEUS features of benign and malignant thyroid solid nodules and CEUS in the thyroid in the differential diagnosis of benign and malignant solid nodules.Methods Use sonovi contrast agent and PHILIPS IU ELITE with L12-5 linear array probe to perform routine high-frequency ultrasound examinations in the Ultrasound Imaging Department of the First Affiliated Hospital of Fujian Medical University from December 2014 to March 2016 of the 63 solid thyroid nodules in 53 patients(TI-RADS category 3 and above)were CEUS to observe the enhancement.Results 1.The typical ultrasound images of papillary thyroid carcinoma include:gradient enhancement,low enhancement,uneven enhancement,late enhancement,early clearance,unclear borders,and irregular edges.2.The diagnostic accuracy rate of conventional high-frequency ultrasound was 79.37%,the diagnostic accuracy rate of contrast-enhanced ultrasound was 85.71%,and the diagnostic accuracy rate of conventional high-frequency ultrasound+contrast-enhanced ultrasound was 93.65%.Conclusion Solid papillary thyroid carcinoma,nodular goiter and thyroid adenoma have their own contrast-enhanced ultrasound imaging characteristics.The diagnostic accuracy of the combined application of contrast-enhanced ultrasound and conventional high-frequency ultrasound is higher than that of conventional high-frequency ultrasound.

关 键 词：超声造影 甲状腺实性结节 良恶性 鉴别诊断 

分 类 号：R4[医药卫生—临床医学]