多模态超声定量参数在甲状腺未分化癌鉴别及癌细胞恶性行为评估中的价值  

The Value of Quantitative Multimodal Ultrasound Parameters in the Identification of Undifferentiated Thyroid Cancer and Assessment of Malignant Behavior of Cancer Cells

作　　者：高净 邱爽 刘晓玲 GAO Jing;QIU Shuang;LIU Xiaoling(Department of Ultrasound Diagnosis,Tangshan Central Hospital,Tangshan 063000,Hebei,P.R.China;Department of Ultrasound,Tangshan People’s Hospital,Tangshan 063000,Hebei,P.R.China)

机构地区：[1]唐山中心医院超声诊断科,河北唐山063000 [2]唐山市人民医院超声科,河北唐山063000

出　　处：《影像科学与光化学》2024年第3期226-232,共7页Imaging Science and Photochemistry

基　　金：河北省医学科学计划项目(20240608)。

摘　　要：目的:探究多模态超声定量参数鉴别诊断甲状腺未分化癌(ATC)的价值及与癌细胞恶性行为的相关性。方法:选取2019年12月至2023年5月唐山中心医院38例ATC患者作为研究组,另选40例原发性甲状腺淋巴瘤(PTL)患者作为对照组,均行多模态超声检查[彩色多普勒血流成像(CDFI)、实时剪切波弹性成像(SWE)、超声造影(CEUS)]。对比两组一般资料、临床特征、多模态超声参数[阻力指数(RI)、收缩期峰值流速(PSV)、弹性模量最小值(Emin)、峰值强度(PI)、平均通过时间(MTT)、达峰时间(TTP)],通过受试者操作特征(ROC)曲线分析多模态超声参数诊断ATC的价值。并比较研究组不同病灶类型、病灶大小、临床分期、淋巴结转移情况患者多模态超声参数,分析多模态超声参数与ATC病灶类型、病灶大小、临床分期、淋巴结转移的相关性。结果:研究组性别、年龄、体质量指数、合并症、颈部肿块、呼吸困难、颈部疼痛、声音嘶哑、吞咽困难与对照组比较,差异无统计学意义(P>0.05);研究组RI、PSV、Emin、TTP高于对照组,PI低于对照组(P<0.05),两组MTT对比,差异无统计学意义(P>0.05);ATC患者临床分期、淋巴结转移与RI、PSV、Emin、TTP呈正相关,与PI呈负相关(P<0.05),与MTT无明显相关性(P>0.05);RI、PSV、Emin、PI、TTP单独诊断ATC的曲线下面积(AUC)分别为0.814、0.814、0.777、0.804、0.786,RI、PSV、Emin、PI、TTP联合诊断的AUC最大,为0.932,诊断敏感度、特异度分别为86.84%、92.50%。结论:多模态超声定量参数在ATC鉴别诊断方面具有较高诊断效能,且与ATC临床分期、淋巴结转移密切相关,有助于评估癌细胞恶性行为。Objective:To investigate the value of multimodal ultrasound quantitative parameters for the differential diagnosis of anaplastic thyroid carcinoma (ATC) and the correlation with the malignant behavior of cancer cells. Methods: 38 ATC patients from Tangshan Central Hospital from Dec 2019 to May 2023 were selected as the study group, and 40 patients with primary thyroid lymphoma (PTL) were selected as the control group, all of whom underwent multimodal ultrasonography [color Doppler flow imaging (CDFI), real-time shear wave elastography (SWE), and contrast-enhanced ultrasound (CEUS)]. The general data, clinical characteristics, and multimodal ultrasound parameters [resistance index (RI), peak systolic velocity (PSV), elastic modulus minimum (Emin), peak intensity (PI), mean transit time (MTT), and time to peak (TTP)] were compared between the two groups, and the value of multimodal ultrasound parameters for diagnosing ATC was analyzed by receiver operator characteristic (ROC) curves. We also compared the multimodal ultrasound parameters in patients with different lesion types, lesion sizes, clinical stages, and lymph node metastases in the study group, and analyzed the correlation between multimodal ultrasound parameters and ATC lesion types, lesion sizes, clinical stages, and lymph node metastases. Results: In the study group, there were no statistically significant differences in gender, age, body mass index, comorbidity, neck mass, dyspnea, neck pain, hoarseness, and dysphagia compared with the control group ( P >0.05). RI, PSV, Emin, and TTP in the study group were higher than those in the control group, and PI was lower than that in the control group ( P <0.05), and MTT in the two groups was not statistically significant ( P > 0.05). Clinical stage and lymph node metastasis of ATC patients were positively correlated with RI, PSV, Emin, and TTP, negatively correlated with PI ( P <0.05), and not significantly correlated with MTT ( P >0.05). The area under the curve (AUC) of RI, PSV, Emin, PI, and TTP for ATC dia

关 键 词：甲状腺未分化癌 原发性甲状腺淋巴瘤 多模态超声 诊断 

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