Wang YanFang, Nie Fang, Liu Ting, Yang Dan, Li Qi, Li Jing, Song AiLing
Department of Ultrasound, Lanzhou University Second Hospital, Lanzhou, Gansu, China.
Department of Ultrasound, Lanzhou University Second Hospital, Lanzhou, Gansu, China.
Ultrasound Med Biol. 2018 May;44(5):930-940. doi: 10.1016/j.ultrasmedbio.2017.12.018. Epub 2018 Feb 19.
The use of ultrasound in differentiation of benign and malignant solid hypo-echoic thyroid nodules is a dilemma in clinical practice. The aim of this study was to investigate the revised value of contrast-enhanced ultrasound (CEUS) for differentiating solid hypo-echoic thyroid nodules using the Thyroid Imaging Reporting and Data System (TI-RADS).The study included 135 patients with 135 nodules confirmed by fine-needle aspiration and/or surgery. Every nodule underwent both conventional US and CEUS. Binary logistic regression analysis for conventional US features revealed that irregular shape, microcalcification and height greater than width were significant malignant predictive features. Binary logistic analysis for CEUS features indicated that hetero-enhancement, slow wash-in, an ill-defined enhancement border and fast wash-out were significantly associated with malignancy. The areas under the curve of the TI-RADS, CEUS and the combination were 0.806, 0.934 and 0.950, respectively. CEUS is a potentially useful tool in the differentiation of solid hypo-echoic thyroid nodules.
在临床实践中，利用超声鉴别甲状腺实性低回声结节的良恶性是一个难题。本研究的目的是利用甲状腺影像报告和数据系统（TI-RADS），探讨超声造影（CEUS）在鉴别甲状腺实性低回声结节方面的修正价值。该研究纳入了135例经细针穿刺和/或手术确诊为135个结节的患者。每个结节均接受了常规超声和CEUS检查。对常规超声特征进行二元逻辑回归分析显示，形态不规则、微钙化以及高大于宽是显著的恶性预测特征。对CEUS特征进行二元逻辑分析表明，不均匀增强、缓慢注入、增强边界不清和快速廓清与恶性肿瘤显著相关。TI-RADS、CEUS及其联合应用的曲线下面积分别为0.806、0.934和0.950。CEUS是鉴别甲状腺实性低回声结节的一种潜在有用工具。
