甲状腺乳头状癌和自发性甲状腺皱缩结节的超声特点分析  

Contrast-enhanced Ultrasonography Analysis for Differential Diagnosis of Papillary Thyroid Carcinomas and Spontaneous Degenerating Cystic Thyroid Nodules

作　　者：杨捷 余晓梅[1] 葛嘉[1] 刘元锋[1] Yang Jie;Yu Xiaomei;Ge Jia;Liu Yuanfeng(Wuhan Hospital of Integrated Traditional Chinese and Western Medicine,Wuhan 430000,China)

机构地区：[1]武汉市中西医结合医院,武汉市430000

出　　处：《中国超声医学杂志》2022年第10期1088-1092,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨和比较甲状腺乳头状癌(PTC)和自发性甲状腺皱缩结节的灰阶超声、彩色多普勒超声和超声造影(CEUS)特点。方法 回顾性分析因甲状腺结节到武汉市中西医结合医院就诊的患者64例,以病理诊断为金标准,将患者分为PTC组和自发性甲状腺皱缩结节组,每组患者各32例。比较两组患者灰阶超声、彩色多普勒超声和超声造影特点。结果 灰阶超声检查显示,两组患者的纵横比、边界和回声等差异有统计学意义(P<0.05),两组患者的钙化和血流差异无统计学意义(P>0.05);彩色多普勒超声检查显示,两组患者的血管分布、穿支状血管、血供级别和RI差异无统计学意义(P>0.05);CEUS检查显示,两组患者CEUS增强水平、增强方式、增强均匀性、环状增强、增强后结节性、增强后结节边界、增强后结节大小、峰值强度(PI)和曲线下面积(AUC)差异具有统计学意义(P<0.05),两组患者的增强、开始增强时间(AT)、峰值时间(TTP)差异无统计学意义(P>0.05)。结论 PTC和自发性甲状腺皱缩结节的彩色多普勒超声特点相当,两者在灰阶超声和CEUS特征均存在差异,具有重要的临床价值。Objective To investigate the clinical value of contrast-enhanced ultrasonography(CEUS) analysis for differential diagnosis of papillary thyroid carcinomas(PTC) and spontaneous degenerating cystic thyroid nodules. Methods A retrospective analysis was performed on 32 patients with single PTC or spontaneous cystic thyroid nodules who received CEUS examination due to thyroid nodules in our hospital. Conventional ultrasound manifestations were compared between 2 groups, and CEUS enhancement mode and time-intensity curve(TIC) were analyzed. Results There were statistically significant differences in aspect ratio, boundary and echo between 2 groups(P<0.05). The typical CEUS features of PTC were low, centripetal and non-uniform enhancement, with irregular shape, unclear boundary and enlarged nodules after enhancement. The typical CEUS findings of spontaneous thyroid nodules were cyclic hyperenhancement. Compared with the normal thyroid tissue around the lesion, most(24/32, 75.00%) PTC showed a slow rising part, a gentle descending part, a low and flat curve, and a later peak value, with lower peak intensity(PI) and area under the curve(AUC) than the surrounding tissue(P<0.05). Most of them(28/32, 87.50%) had a slightly higher ascending curve, and there was no significant difference between PI and surrounding normal tissue(P>0.05), but TTP was slightly later than that of normal tissue(P<0.05). Conclusions There were some differences between PTC and spontaneous thyroid gland nodules in CEUS qualitative and quantitative analysis. On the basis of conventional ultrasound examination, CEUS examination has important clinical value in distinguishing PTC from idiopathic thyroid nodules.

关 键 词：甲状腺结节 乳头状癌 自发性甲状腺皱缩结节 超声造影 诊断 

分 类 号：R736.1[医药卫生—肿瘤] R445.1[医药卫生—临床医学] R581