超声造影联合临床特征在微波消融治疗甲状腺良性结节疗效中的预测作用  

Contrast-enhanced ultrasound combined with clinical characteristics in predicting the efficacy of microwave ablation for the treatment of benign thyroid nodules

作　　者：杨荣娇 王静 陈海燕 成家茂 张代娣 陈国卿 YANG Rongjiao;WANG Jing;CHEN Haiyan;CHENG Jiamao;ZHANG Daidi;CHEN Guoqing(Clinical Medicine College of Dali University,Dali,Yunnan 671000,China;Department of Ultrasound,the First Affiliated Hospital of Dali University,Dali,Yunnan 671000,China;Basic Medicine College of Dali University,Dali,Yunnan 671000,China)

机构地区：[1]大理大学临床医学院,云南大理671000 [2]大理大学第一附属医院超声科,云南大理671000 [3]大理大学基础医学院,云南大理671000

出　　处：《影像研究与医学应用》2024年第2期7-11,14,共6页Journal of Imaging Research and Medical Applications

基　　金：2023年云南省教育厅科学研究基金项目(2023J0905)。

摘　　要：目的:探讨超声造影(CEUS)定量参数联合临床特征预测微波消融(MWA)治疗良性甲状腺结节(BTN)疗效的临床价值。方法:回顾性分析2021年12月—2022年8月在大理大学第一附属医院接受MWA治疗的112例BTN患者的临床资料及超声检查结果,计算术后第12个月末的结节体积(V术后)和体积缩小率(VRR)。以术后第12个月末的VRR为依据分成高消融率组(VRR≥80%,n=85)和低消融率组(VRR<80%,n=27)。采用单因素分析法比较两组患者MWA术前的一般资料、临床特征及CEUS定量参数如达峰时间(TTP)、峰值强度(PI)、上升时间(RT)、曲线下面积(AUC-CEUS),筛选出影响消融率相关因素,并以此作为变量进行多因素Logistic回归分析法,分析MWA疗效的风险因素。结果:采用单因素分析进行高、低消融率组间比较的结果显示,消融术前结节的最大直径、体积、位置、消融风险及PI、TTP、AUC-CEUS差异均有统计学意义(P<0.05),与消融率相关。采用多因素Logistic回归分析结果显示,消融风险等级中的高风险、TTP、AUC-CEUS是MWA治疗BTN疗效的风险因素(P<0.05),且受试者工作特征(ROC)曲线分析的AUC为0.984,灵敏度为91.8%,特异度为96.3%。结论:CEUS定量参数TTP、AUC结合临床特征中的高消融风险可作为有效预测MWA治疗BTN患者效果的风险因素。Objective To explore the clinical value of the quantitative parameters of contrast-enhanced ultrasound(CEUS)combined with clinical characteristics in predicting the efficacy of microwave ablation(MWA)for the treatment of benign thyroid nodules(BTN).Methods Retrospective analysis of clinical data and ultrasound examination results of 112 BTN patients who received MWA treatment at the First Affiliated Hospital of Dali University from December 2021 to August 2022,and the postoperative volume(VPO)and the volume reduction rate(VRR)of BTN were calculated at the end of 12th month after MWA,respectively.A high ablation rate group(VRR≥80%,n=85)and a low ablation rate group(VRR<80%,n=27)were divided based on the VRR at the end of 12th month after MWA.The general data,clinical characteristics,and the quantitative parameters of CEUS such as time to peak(TTP),peak intensity(PI),rise time(RT),and the area under curve(AUC-CEUS)were compared between two groups by the univariate analysis for screening out the factors related to the absorption rate,which were analyzed as variables by the multivariate logistic regression analysis to acquire the risk factors for predicting the efficacy of MWA.Results Comparing between the high and low ablation rate groups via univariate analysis,the results showed that the maximum diameter,volume,location of BTN before ablation,the ablation risk,and the PI,TTP,and AUC-CEUS were statistically significant(P<0.05),which were correlated with ablation rates.After the multivariate regression analysis,the results showed that the high-risk grade of ablation,TTP,and AUC-CEUS were the risk factors of MWA in treating BTN(P<0.05),and AUC of the receiver operating characteristic(ROC)curve was 0.984,with a sensitivity of 91.8%and a specificity of 96.3%.Conclusion TTP and AUC as the quantitative parameters of CEUS combined with the high-risk grade of ablation as a clinical characteristic,can serve as the effective risk factors to predict the therapeutic effect of MWA for BTN patients.

关 键 词：甲状腺良性结节 微波消融术 超声造影 临床特征 风险预测 

分 类 号：R445.1[医药卫生—影像医学与核医学]