甲状腺结节中应用 superb microvascular imaging（SMI）和 CD34 表达组织学分析血管生成：一项初步研究。
Analysis of vascularization in thyroid gland nodes with superb microvascular imaging (SMI) and CD34 expression histology: a pilot study.
机构信息
Department of Internal Medicine I, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
Department of Diagnostic and Interventional Radiology, Ulm University Hospital, Albert-Einstein-Alee 23, 89081, Ulm, Germany.
出版信息
BMC Med Imaging. 2021 Oct 30;21(1):159. doi: 10.1186/s12880-021-00690-5.
BACKGROUND
The Doppler sonography technique known as "superb microvascular imaging" (SMI) is advancing sonographic micro vascularization imaging in various disciplines. In this study, we aimed to determine whether SMI could reliably reproduce the blood flow in thyroid nodes and whether malignancy could be diagnosed, based on vascularization properties. Immunhistochemical staining by CD34 and SMI where used to determine the vascularization of nodes in terms of quantified vascularization parameters gained by computational evaluation.
METHODS
We used image analysis programs to investigate whether the quantitative value for vascularization strength in the thyroid node, measured with SMI, was correlated with the actual degree of vascularization, determined microscopically. We included 16 patients that underwent thyroid resections. We prepared thyroid gland tissue slices for immunohistochemistry and labelled endothelial cells with CD34 to visualize blood vessels microscopically. We used image analysis programs, ImageJ, to quantify SMI Doppler sonographic measurements and CellProfiler to quantify CD34 expression in histological sections. We evaluated the numeric values for diagnostic value in node differentiation. Furthermore, we compared these values to check for correlations.
RESULTS
Among the 16 nodes studied, three harboured malignant tumours (18.75%): two papillary and one follicular carcinoma. Among the 13 benign lesions (81.25%), four harboured follicular adenomas. Malignant and benign nodes were not significantly different in sonographic (0.88 ± 0.89 vs. 1.13 ± 0.19; p = 0.2790) or immunohistochemical measurements of vascularization strength (0.05 ± 0.05 vs. 0.08 ± 0.06; p = 0.2260).
CONCLUSION
We found a positive, significant correlation (r = 0.55588; p = 0.0254) between SMI (quantitative values for vascularization strength) and immunohistochemistry (CD34 staining) evaluations of thyroid nodes.
背景
被称为“超级微血管成像”（SMI）的多普勒超声技术正在推动各个学科的超声微血管成像。在这项研究中，我们旨在确定 SMI 是否能够可靠地再现甲状腺结节中的血流，并根据血管生成特性诊断恶性肿瘤。使用 CD34 免疫组织化学染色和 SMI 来确定通过计算评估获得的量化血管生成参数的节点血管生成。
方法
我们使用图像分析程序来研究通过 SMI 测量的甲状腺节点血管生成强度的定量值是否与通过显微镜确定的实际血管生成程度相关。我们纳入了 16 例接受甲状腺切除术的患者。我们准备甲状腺组织切片进行免疫组织化学染色，并使用 CD34 标记内皮细胞以在显微镜下观察血管。我们使用图像分析程序 ImageJ 来量化 SMI 多普勒超声测量值，并使用 CellProfiler 来量化组织切片中的 CD34 表达。我们评估了在节点分化中用于诊断价值的数值。此外，我们比较了这些值以检查相关性。
结果
在所研究的 16 个节点中，有三个节点存在恶性肿瘤（18.75%）：两个乳头状癌和一个滤泡状癌。在 13 个良性病变中（81.25%），有四个存在滤泡性腺瘤。在超声（0.88±0.89 与 1.13±0.19；p=0.2790）或血管生成强度的免疫组织化学测量方面，恶性和良性节点之间没有显著差异（0.05±0.05 与 0.08±0.06；p=0.2260）。
结论
我们发现 SMI（血管生成强度的定量值）与甲状腺节点的免疫组织化学（CD34 染色）评估之间存在正相关（r=0.55588；p=0.0254）。
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