Wiesinger I, Kroiss E, Zausig N, Hornung M, Zeman F, Stroszczynski C, Jung E M
Department of Radiology, University Medical Center Regensburg, Regensburg, Germany.
Department of Surgery, University Medical Center Regensburg, Regensburg, Germany.
Clin Hemorheol Microcirc. 2016;64(4):747-755. doi: 10.3233/CH-168044.
To determine different perfusion characteristics of histo-pathologically proven adenomas and carcinomas of the thyroid gland with CEUS and perfusion software.
Retrospective perfusion analysis of 25 patients with carcinomas and 41 cases of adenomas of the thyroid gland (30 males, 36 females; aged 18 - 85 years, mean 56 years). All cases were histologically analyzed. Perfusion analysis was independently performed using external perfusion software (VueBox®). TTP, mTT, Peak and Rise time were calculated.
Lesions' sizes ranged from 0.2 to 10.2 cm in carcinomas (mean 2.18 cm), and from 0.6 to 5.0 cm in adenomas (mean 2.25 cm). In 20 out of 25 carcinomas that were evaluated with CEUS, a complete wash-out in the late venous phase was found. Adenomas showed wash-out at the border.Perfusion analysis in VueBox® revealed some parameters which tend to show differences between adenomas and carcinomas, however did not reach the level of significance.Median Peak in carcinomas was highest at the margins (2945 rU), and lowest in the surroundings (1110 rU). Mean Transit Time (mTT) values showed no differences between center, margin and surrounding.In adenomas healthy tissue showed higher mTT values compared to the center (24.6 vs. 20.7 sec). Median Peak was highest in the surrounding tissue and lowest in the margins (1999 vs. 1129 rU). No statistical differences could be found in the comparisons.
CEUS with perfusion analysis offers new possibilities for the dynamic evaluation of micro-vascularization in thyroid adenomas and carcinomas. Using VueBox® the perfusion analysis of the arterial phase provides new parameters that help determine a lesion's malignancy or benignity. However a final assessment regarding malignancy and benignity of thyroid lesions using only CEUS and perfusion analysis of the arterial phase is not yet possible.
运用超声造影（CEUS）及灌注软件确定经组织病理学证实的甲状腺腺瘤和癌的不同灌注特征。
对25例甲状腺癌患者和41例甲状腺腺瘤患者（男30例，女36例；年龄18 - 85岁，平均56岁）进行回顾性灌注分析。所有病例均进行了组织学分析。使用外部灌注软件（VueBox®）独立进行灌注分析。计算了达峰时间（TTP）、平均通过时间（mTT）、峰值及上升时间。
癌灶大小范围为0.2至10.2厘米（平均2.18厘米），腺瘤大小范围为0.6至5.0厘米（平均2.25厘米）。在25例接受CEUS评估的癌灶中，20例在静脉晚期出现完全廓清。腺瘤在边界处出现廓清。VueBox®中的灌注分析显示了一些倾向于在腺瘤和癌之间表现出差异的参数，但未达到显著水平。癌灶边缘的峰值中位数最高（2945 rU），周围最低（1110 rU）。平均通过时间（mTT）值在中心、边缘和周围之间无差异。在腺瘤中，健康组织的mTT值高于中心（24.6对20.7秒）。峰值中位数在周围组织中最高，在边缘最低（1999对1129 rU）。比较中未发现统计学差异。
CEUS结合灌注分析为甲状腺腺瘤和癌的微血管化动态评估提供了新的可能性。使用VueBox®对动脉期进行灌注分析提供了有助于确定病变良恶性的新参数。然而，仅使用CEUS和动脉期灌注分析对甲状腺病变的良恶性进行最终评估尚不可能。
