定量分析对超声造影低增强型亚急性甲状腺炎与甲状腺乳头状癌的鉴别诊断价值  

Value of quantitative analysis in differential diagnosis of hypo-enhanced subacute thyroiditis and papillary thyroid carcinoma

作　　者：王娴 荣新 曹海艳 王磊[2] 戚庭月[1] WANG Xian;RONG Xin;CAO Hai-yan;WANG Lei;QI Ting-yue(Department of Ultra-sound,Medical Imaging Center,Affiliated Hospital of Yangzhou University,Yangzhou 225100,Jiangsu,China;Department of Pathology,Affiliated Hospital of Yangzhou University,Yangzhou 225100,Jiangsu,China;Department of Ultrasound,the Second People’s Hospital of Lianyungang,Lianyungang 222000,Jiangsu,China)

机构地区：[1]扬州大学附属医院医学影像中心超声科,江苏扬州225100 [2]扬州大学附属医院病理科,江苏扬州225100 [3]连云港市第二人民医院超声科,江苏连云港222000

出　　处：《生物医学工程与临床》2023年第2期185-190,共6页Biomedical Engineering and Clinical Medicine

基　　金：扬州市科技局重点研发项目(YZ2020099)。

摘　　要：目的利用超声造影(CEUS)定量分析技术获取不同甲状腺结节的定量参数,评价其对低增强型亚急性甲状腺炎(SAT)与甲状腺乳头状癌(PTC)的鉴别诊断价值。方法选择32例SAT患者作为SAT组,其中男性6例,女性26例;年龄36~66岁,平均年龄50.37岁;结节大小6.0~36.7 mm,平均最大径13.54 mm。同期选择经术后病理诊断证实39例PTC患者作为PTC组,其中男性9例,女性30例;年龄33~66岁,平均年龄48.28岁;结节大小7.0~23.0 mm,平均最大径11.94 mm。运用SonoLiver软件分析记录各结节整体(W)、边缘(P)和中央(C)的不同感兴趣区(ROI)的CEUS定量参数,包括最大峰值强度(IMAX)、始增时间(RT)、达峰时间(TTP)和平均渡越时间(mTT),并计算周围正常组织各定量参数与结节不同部位定量参数的相对值(△值),对比分析SAT和PTC两组结节之间CEUS定量参数的差异,并用受试者工作特性(ROC)曲线获得截断值。结果SAT组结节定量参数IMAX_(W)和△mTT_(W)大于PTC组(0.53±0.18 vs 0.43±0.23;P<0.05。-1.26±7.35 vs-1.44±2.38;P<0.05);△TTP_(P)在SAT组小于PTC组(-0.42±0.66 vs 0.06±0.75。P<0.05);SAT组定量参数IMAX_(C)、△RT_(C)及△mTT_(C)均高于PTC组(0.49±0.19 vs 0.31±0.28;P<0.05。0.24±0.62 vs-0.28±1.11;P<0.05。1.31±4.32 vs-1.62±4.35;P<0.05)。ROC曲线分析显示定量参数IMAX_(C)及△mTT_(C)的最佳截断值分别为0.27和0.50,曲线下面积分别为0.849和0.837。结论CEUS定量分析有助于低增强型SAT与PTC的鉴别,有一定的临床应用价值。Objective To explore the quantitative parameters of different thyroid nodules obtained by contrast-enhanced ul trasound(CEUS) quantitative analysis technology,and evaluate its value in differential diagnosis of hypo-enhanced subacute thyroiditis(SAT) and papillary thyroid carcinoma(PTC).Methods A total of 32 patients with SAT were enrolled as SAT group,which included 6 males and 26 females,aged 36-66 years old with mean age of 50.37 years old;size of nodules was 6.0-36.7 mm with mean maximum diameter of 13.54 mm.At the same time,39 PTC patients confirmed by postoperative pathological diagnosis were set as PTC group,which included 9 males and 30 females,aged 33-66 years old with mean age of 48.28 years old;size of nodules was 7.0-23.0 mm with mean maximum diameter of 11.94 mm.The SonoLiver software was used to analyze and record the CEUS quantitative parameters of different regions of interest(ROI) in the whole(W),peripheral(P) and central (C) of each nodule,which included maximum intensity (IMAX),rise time (RT),time to peak (TTP) and mean transit time (mTT),and relative values (△value) of quantitative parameters of surrounding normal tissues and quantitative parameters of different parts of nodules were calculated.The differences of CEUS quantitative parameters between SAT and PTC nodules were compared and analyzed,and the cut-off values were obtained by receiver operating characteristic (ROC)curve.Results The IMAX_(W) and △mTT_(W) of SAT groups were higher than those of PTC nodules(0.53±0.18 vs 0.43±0.23;P<0.05.-1.26±7.35 vs-1.44±2.38;P<0.05);The △TTP_(P) of SAT group was lower than that of PTC group(-0.42±0.66 vs0.06±0.75.P<0.05).The values of IMAX_(C),△RT_(C) and △mTT_(C)of SAT group were higher than those of PTC group(0.49±0.19vs 0.31±0.28;P<0.05.0.24±0.62 vs-0.28±1.11;P<0.05.1.31±4.32 vs-1.62±4.35;P<0.05).The ROC curve analysis showed that the optimal truncation values of IMAX_(C) and △mTT_(C) were 0.27 and 0.50,and areas under the curve were 0.849 and0.837,respectively.Conclusion It

关 键 词：亚急性甲状腺炎 甲状腺乳头状癌 超声造影 时间-强度曲线(TIC) 

分 类 号：R445.1[医药卫生—影像医学与核医学] R581.4[医药卫生—诊断学] R736.1[医药卫生—临床医学]