甲状腺声晕结节的二维超声及超声造影分析
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摘要
目的探讨声晕特征的二维超声及超声造影表现在甲状腺结节诊断中的意义。方法采用回顾性研究的方法,选取2017年1～12月在首都医科大学附属北京友谊医院超声科同时进行甲状腺二维超声及超声造影检查的47例具有声晕特征的甲状腺结节按照二维超声下声晕的粗细、是否均匀、是否光滑进行分组,另取2018年1月1～31日于同一医院行二维超声检查的198例甲状腺结节按照有无声晕特征进行分组,探讨不同声晕特征在甲状腺良性结节与恶性结节中的发生率是否具有统计学差异。同时观察47例声晕结节的造影表现,将其与病理结果进行对照分析。结果有声晕、不光滑声晕及不均匀声晕在甲状腺恶性结节中发生率较高(与良性结节组比较P <0. 05或0. 01)。造影结果中,声晕低增强多见于甲状腺恶性结节,如果以声晕低增强为标准诊断甲状腺乳头状癌,其敏感度及特异度分别为91. 67%及82. 60%。结论超声造影可有效鉴别甲状腺声晕结节的良恶性,以造影声晕低增强来诊断甲状腺恶性肿瘤,有较高的敏感度和特异度。
Objective To evaluate the diagnosis value of ultrasound( US) and contrast-enhanced ultrasound( CEUS) in thyroid nodule with halo feature. Methods The US features of thyroid nodules with halo feature,in 47 nodules seen at Beijing friendship hospital between January 2017 and December 2017 were retrospectively reviewed. Characteristic features,including hale's thickness,regularity,border and the imaging model of CEUS were recorded and compared between the benign nodules and malignant nodules. And other 198 thyroid nodules from January 1 2018 and January 31 2018 at the same hospital were observed whether there was a halo. Results The number of nodules with halo feature and with rough halo in malignant thyroid nodules was more than that in benign thyroid nodules with statistically difference( P < 0. 05 or P < 0. 01).The hypoenhancement degree of the halo usually existed in malignant nodules. Papillary thyroid cancer could be diagnosed based on hypoenhancement of CEUS with sensitivity 91. 67% and specififty 82. 60%. Conclusion CEUS shows a good diagnostic capability in thyroid nodules with halo feature.
Objective To evaluate the diagnosis value of ultrasound( US) and contrast-enhanced ultrasound( CEUS) in thyroid nodule with halo feature. Methods The US features of thyroid nodules with halo feature,in 47 nodules seen at Beijing friendship hospital between January 2017 and December 2017 were retrospectively reviewed. Characteristic features,including hale's thickness,regularity,border and the imaging model of CEUS were recorded and compared between the benign nodules and malignant nodules. And other 198 thyroid nodules from January 1 2018 and January 31 2018 at the same hospital were observed whether there was a halo. Results The number of nodules with halo feature and with rough halo in malignant thyroid nodules was more than that in benign thyroid nodules with statistically difference( P < 0. 05 or P < 0. 01).The hypoenhancement degree of the halo usually existed in malignant nodules. Papillary thyroid cancer could be diagnosed based on hypoenhancement of CEUS with sensitivity 91. 67% and specififty 82. 60%. Conclusion CEUS shows a good diagnostic capability in thyroid nodules with halo feature.
引文
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[10]Girardi FM,Silva LMD,Flores CD.A predictive model to distinguish malignant and benign thyroid nodules based on age,gender and ulrasonographic features[J].Braz J Otorhinolaryngol,2019,85(1):24-31.
[11]He YP,Xu HX,Zhao CK,et al.Cytologically indeterminate thyroid nodules:increased diagnostic performance with combination of US TI-RADS and a new scoring system[J].Sci Rep,2017,7(1):6906.
[12]Oliveira CM,Costa RA,Patrício M,et al.Sonographic Criteria Predictive of Malignant Thyroid Nodules:Which Lesions Should be Biopsied[J]?Acad Radiol,2018,25(2):213-218.
[13]Schleder S,Janke M,Agha A,et al.Preoperative differentiation of thyroid adenomas and thyroid carcinomas using high resolution contrastenhanced ultrasound(CEUS)[J].Clin Hemorheol Microcirc,2015,61(1):13-22.
[14]Agha A,Jung EM,Janke M,et al.Preoperative diagnosis of thyroid adenomas using high resolution contrast-enhanced ultrasound(CEUS)[J].Clin Hemorheol Microcirc,2013,55(4):403-409.
[15]张燕,罗渝昆,张明博,等.超声造影周边环状增强对甲状腺结节鉴别诊断的意义[J/CD].中华医学超声杂志(电子版),2016,13(1):31-35.
[2]Shaheen R,Levine D.Diagnostic Ultrasound[M].4 ed.Philadelphia:Elsevier,2011:711-721.
[3]Haugen BR.2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer:What is new and what has changed[J]?Cancer,2017,123(3):372-381.
[4]Moon WJ,Baek JH,Jung SL,et al.Ultrasonography and the ultrasound-based management of thyroid nodules:consensus statement and recommendations[J].Korean J Radiol,2011,12(1):1-14.
[5]Anil G,Hegde A,Chong FH.Thyroid nodules:risk stratification for malignancy with ultrasound and guided biopsy[J].Cancer Imaging,2011,11:209-223.
[6]Lacout A,Chevenet C,Marcy PY.Mummified Thyroid Syndrome[J].AJR Am J Roentgenol,2016,206(4):837-845.
[7]Cochand-Priollet B,Vielh P,Royer B,et al.Thyroid cytopathology:Bethesda System 2010[J].Ann Pathol,2012,32(3):177-183.
[8]Liu MJ,Men YM,Zhang YL,et al.Improvement of diagnostic efficiency in distinguishing the benign and malignant thyroid nodules via conventional ultrasound combined with ultrasound contrast and elastography[J].Oncol Lett,2017,14(1):867-871.
[9]Pompili GG,Tresoldi S,Ravelli A,et al.Use of the ultrasound-based total malignancy score in the management of thyroid nodules[J].Ultrasonography,2018,37(4):315-322.
[10]Girardi FM,Silva LMD,Flores CD.A predictive model to distinguish malignant and benign thyroid nodules based on age,gender and ulrasonographic features[J].Braz J Otorhinolaryngol,2019,85(1):24-31.
[11]He YP,Xu HX,Zhao CK,et al.Cytologically indeterminate thyroid nodules:increased diagnostic performance with combination of US TI-RADS and a new scoring system[J].Sci Rep,2017,7(1):6906.
[12]Oliveira CM,Costa RA,Patrício M,et al.Sonographic Criteria Predictive of Malignant Thyroid Nodules:Which Lesions Should be Biopsied[J]?Acad Radiol,2018,25(2):213-218.
[13]Schleder S,Janke M,Agha A,et al.Preoperative differentiation of thyroid adenomas and thyroid carcinomas using high resolution contrastenhanced ultrasound(CEUS)[J].Clin Hemorheol Microcirc,2015,61(1):13-22.
[14]Agha A,Jung EM,Janke M,et al.Preoperative diagnosis of thyroid adenomas using high resolution contrast-enhanced ultrasound(CEUS)[J].Clin Hemorheol Microcirc,2013,55(4):403-409.
[15]张燕,罗渝昆,张明博,等.超声造影周边环状增强对甲状腺结节鉴别诊断的意义[J/CD].中华医学超声杂志(电子版),2016,13(1):31-35.