微血流模式背景下超声造影对甲状腺癌的血流评估  

Evaluation of blood fl ow in thyroid carcinoma by contrast-enhanced ultrasound and micro-fl ow imaging

作　　者：刘昕[1] 苏泳安 李晓青[1] Liu Xin;Su Yongan;Li Xiaoqing(Ultrasound Department,Baoding First Central Hospital,Baoding 071000,China)

机构地区：[1]保定市第一中心医院超声科,河北保定071000

出　　处：《实用肿瘤杂志》2024年第1期75-79,共5页Journal of Practical Oncology

基　　金：保定市科技计划项目(2341ZF239)。

摘　　要：目的 通过比较微血流成像(micro-flow imaging,MFI)模式背景下超声造影(contrast-enhanced ultrasound,CEUS;CEUS+MFI)、MFI和彩色多普勒超声(color Doppler flow imaging,CDFI)显示甲状腺结节血流分布的能力,确定检测甲状腺结节血流最准确的成像模式及特异度较高的血流特征。方法 回顾性收集2021年3月至2022年3月于保定市第一中心医院就诊的甲状腺结节患者92例(共92个结节)的临床资料和超声影像学资料。所有患者均采用CEUS+MFI、MFI和CDFI观察结节内部血流分型及血管特征。所有结节根据术后病理结果分为良性结节组(n=41)及恶性结节组(n=51),比较两组结节间超声征象的差异。绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析CEUS+MFI、MFI和CDFI鉴别甲状腺结节良恶性的诊断效能。结果 41个良性结节以Ⅱ型血流为主,51个恶性结节以Ⅲ型血流为主。CEUS+MFI诊断甲状腺癌的敏感度和特异度分别为96.1%和95.1%,约登指数为0.912;ROC曲线下面积为0.941,高于MFI和CDFI(均P<0.05)。CEUS+MFI对甲状腺癌的血管走行扭曲和分支异常的检出率均高于CDFI和MFI(均P<0.05)。结论 甲状腺良恶性结节在血流分布模式方面存在差异;CEUS+MFI可提供更准确的血流诊断依据。Objective To determine the most accurate imaging mode and the highly specific blood flow characteristics for assessing blood flow in thyroid nodules by comparing the ability of contrast-enhanced ultrasound combined with micro-flow imaging(CEUS+MFI),micro-flow imaging(MFI),and color Doppler flow imaging(CDFI)to display the blood flow distribution in thyroid nodules.Methods The clinical and ultrasound imaging data of 92 patients with thyroid nodules(92 nodules)treated at Baoding First Central Hospital from March 2021 to March 2022 were collected retrospectively.All patients received CEUS+MFI,MFI,and CDFI to assess internal blood flow patterns and vascular characteristics of the nodules.Based on postoperative pathological results,the nodules were divided into benign and malignant nodule groups.Ultrasound signs was compared between the two groups.The diagnostic efficacy of CEUS+MFI,MFI,and CDFI in distin-guishing benign and malignant thyroid nodules was analyzed by receiver operating characteristic(ROC)curve.Results 41 benign nodules mainly had typeⅡblood flow,51 malignant nodules mainly had typeⅢblood flow.The sensitivity and specificity of CEUS+MFI in diag-nosing thyroid cancer were 96.1%and 95.1%,respectively.The Youden index was 0.912.The area under the curve was 0.941,which was higher than those of MFI and CDFI(both P<0.05).The detection rates of vascular distortion and branch abnormalities in thyroid cancer by CEUS+MFI were higher than those by CDFI and MFI(all P<0.05).Conclusions There are significant differences in blood flow dis-tribution patterns between benign and malignant thyroid nodules;CEUS+MFI can provide more accurate diagnosis based on blood flow evaluation.

关 键 词：甲状腺癌 甲状腺结节 微血管成像 超声造影 

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]