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超声造影鉴别诊断甲状腺微小钙化结节良恶性的价值

Value of differential diagnosis of contrast-enhanced ultrasound in benign and malignant thyroid nodules with microcalcification.

作者信息

Gao Zhixiang, Lu Qin, Yan Jiping

机构信息

Department of Ultrasound, People's Hospital of Shanxi Province, Taiyuan, Shanxi 030012, P.R. China.

出版信息

Oncol Lett. 2019 May;17(5):4545-4549. doi: 10.3892/ol.2019.10107. Epub 2019 Mar 4.

Abstract

Value of differential diagnosis of contrast-enhanced ultrasound in benign and malignant thyroid nodules with microcalcification was explored. A total of 184 patients with thyroid nodules with microcalcification, treated in People's Hospital of Shanxi Province from April 2015 to March 2017, were selected as research subjects. Contrast-enhanced ultrasound was used for imaging examination of the thyroid nodules. Three regions of interest were drawn at the positions with the strongest ultrasound imaging, for which the time-intensity curve (TIC), time to peak (Tp), peak intensity (Peak), area under curve (AUC) and mean transit time (MTT) were obtained separately. The features of contrast-enhanced ultrasound for malignant thyroid nodules were manifested as irregular focus edge, unclear boundary, low fiber reinforcement of the whole focus, uneven distribution of images and blood perfusion defect inside the focus, especially severe blood perfusion defect in the nodule center. The TIC showed a slow ascending and slow descending trend in general. The TIC features and the features of contrast-enhanced ultrasound for malignant thyroid nodules were prominently different from those for benign thyroid nodules. Compared with those in the surrounding normal tissues of thyroid gland, the Peak was remarkably shorter, and the AUC was notably smaller in the center and edge of malignant thyroid nodules (P<0.05); and the nodule center had obviously shorter Peak and smaller AUC than the nodule edge (P<0.05). Furthermore, in comparison with those of malignant thyroid nodules, the Peak was extended and AUC was enlarged markedly in the center and edge of benign thyroid nodules (P<0.05). In conclusion, the contrast-enhanced ultrasound can preferably compare the lesions of benign and malignant thyroid nodules with microcalcification, which possesses certain value in the differential diagnosis of benign and malignant thyroid nodules.

摘要

探讨超声造影在伴有微钙化的甲状腺良恶性结节鉴别诊断中的价值。选取2015年4月至2017年3月在山西省人民医院就诊的184例伴有微钙化的甲状腺结节患者作为研究对象。采用超声造影对甲状腺结节进行成像检查。在超声成像最强的部位绘制三个感兴趣区,分别获取其时间-强度曲线(TIC)、达峰时间(Tp)、峰值强度(Peak)、曲线下面积(AUC)及平均通过时间(MTT)。甲状腺恶性结节的超声造影特征表现为病灶边缘不规则、边界不清、整个病灶纤维增强低、图像分布不均匀及病灶内部血流灌注缺损,尤其是结节中心血流灌注缺损严重。TIC总体呈缓慢上升和缓慢下降趋势。甲状腺恶性结节的TIC特征及超声造影特征与良性甲状腺结节明显不同。与甲状腺周围正常组织相比,甲状腺恶性结节中心及边缘的Peak明显缩短,AUC明显减小(P<0.05);结节中心的Peak明显短于结节边缘,AUC明显小于结节边缘(P<0.05)。此外,与甲状腺恶性结节相比,良性甲状腺结节中心及边缘的Peak延长,AUC明显增大(P<0.05)。综上所述,超声造影能够较好地比较伴有微钙化的甲状腺良恶性结节的病变情况,在甲状腺良恶性结节的鉴别诊断中具有一定价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/999a/6444473/f14f991f6ec8/ol-17-05-4545-g00.jpg

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