超声造影在甲状腺结节良恶性鉴别诊断中的价值
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摘要
目的探讨超声造影在鉴别甲状腺良、恶性结节中的应用价值。方法对96例甲状腺结节患者共152个结节术前行超声造影检查,观察其超声造影增强模式特征,并与病理结果进行对照分析。结果术后病理结果,良性结节75个,恶性结节77个。良性结节超声造影主要表现为等增强或高增强、无增强及环状增强(64/75),多呈均匀性增强(43/75);恶性结节超声造影主要表现为早期低增强或低增强,无环绕增强(70/77),多呈不均匀增强(74/77)。超声造影的增强强度、增强模式、有无环绕增强,在甲状腺良恶性结节鉴别中具有显著相关性,差异有统计学意义(P<0.01)。结论超声造影在甲状腺结节良恶性鉴别诊断中能提供更多有效的诊断信息。
Objective To investigate the value of contrast-enhanced ultrasonography in differentiating benign and malignant thyroid nodules. Methods A total of 152 nodules in 96 patients with thyroid nodules were examined by contrast-enhanced ultrasound,and the contrast enhanced mode features of the nodules were observed and compared with the pathological results. Results Postoperative pathological results included 75 benign nodules and 77 malignant nodules. Benign nodular contrast-enhanced ultrasonography showed enhanced or enhanced enhancement,no enhancement and annular enhancement(64/75),mostly homogeneous enhancement(43/75);Malignant nodules were mainly characterized by early low enhancement or low enhancement,no surround enhancement(70/77),mostly non-uniform enhancement(74/77). The enhanced intensity,enhancement mode and surround enhancement of CEUS have significant correlation in the differentiation of benign and malignant thyroid nodules,and the difference is statistically significant(P<0.01). Conclusion CEUS can provide more effective diagnostic information for the differential diagnosis of benign and malignant thyroid nodules.
Objective To investigate the value of contrast-enhanced ultrasonography in differentiating benign and malignant thyroid nodules. Methods A total of 152 nodules in 96 patients with thyroid nodules were examined by contrast-enhanced ultrasound,and the contrast enhanced mode features of the nodules were observed and compared with the pathological results. Results Postoperative pathological results included 75 benign nodules and 77 malignant nodules. Benign nodular contrast-enhanced ultrasonography showed enhanced or enhanced enhancement,no enhancement and annular enhancement(64/75),mostly homogeneous enhancement(43/75);Malignant nodules were mainly characterized by early low enhancement or low enhancement,no surround enhancement(70/77),mostly non-uniform enhancement(74/77). The enhanced intensity,enhancement mode and surround enhancement of CEUS have significant correlation in the differentiation of benign and malignant thyroid nodules,and the difference is statistically significant(P<0.01). Conclusion CEUS can provide more effective diagnostic information for the differential diagnosis of benign and malignant thyroid nodules.
引文
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[13]瞿秀兰,张建国,郭丽丽,等.甲状腺占位病变的彩色多普勒超声与病理对照观察[J].中华超声影像学杂志,2009,9(6):382-383.
[14]胡菊萍,栗翠英,林红军.超声造影对甲状腺良恶性结节的诊断价值[J].临床超声医学杂志,2014,16(8):534-537.
[2]Pitre-Champagnat S,Leguerney I,Bosq J,et al.Dynamic Contrastenhanced ultrasound parametric maps to evaluate intratumoral vascularization[J].Invest Radiol,2015,50(4):212-217.
[3]Md HB,Alexander EK,Bible KC,et al.2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer[J].Thyroid,2016,26(1):1-133.
[4]Stewart BW,Wild C.World cancer report 2014[M].WHO:Switzerland,2014:630-630.
[5]Kim DW,Jung SJ,Eom JW,et al.Color Doppler features of solid,round,isoechoic thyroid nodules without malignant sonographic features:a prospective cytopathological study[J].Thyroid,2012,23(5):472-476.
[6]文芳.细针穿刺细胞学检查在甲状腺疾病中的临床应用[J].江西医药,2011,46(3):284-285.
[7]Hornung M,Jung EM,Georgieva M,et al.Detection of microvascularization of thyroid carcinomas using linear high resolution contrast enhanced ultrasonography(CEUS)[J].Clin Hemorheol Microcirc,2012,52(4):197-203.
[8]徐本华,丁红,王文平,等.甲状腺实性结节的实时超声造影表现和特征[J].中国超声医学杂志,2010,26(8):695-698.
[9]Zhang L,Wei WJ,Ji QH,et al.Risk factors for neck nodal metastasis in papillary thyroid microcarcinoma:a study of 1066patients[J].J Clin Endocrinol Metab,2012,97(4):1250-1257.
[10]周琦,姜珏,杜晓鹏,等.超声造影在甲状腺乳头状癌中的诊断价值[J].中国超声医学杂志,2011,27(7):595-597.
[11]纪小龙,吉米.甲状腺病理诊断[M].北京:人民军医出版.2011.328.
[12]程英.21例甲状腺乳头状癌的临床病理学分析[J].江西医药,2010,45(9):929-931.
[13]瞿秀兰,张建国,郭丽丽,等.甲状腺占位病变的彩色多普勒超声与病理对照观察[J].中华超声影像学杂志,2009,9(6):382-383.
[14]胡菊萍,栗翠英,林红军.超声造影对甲状腺良恶性结节的诊断价值[J].临床超声医学杂志,2014,16(8):534-537.