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目的:讨论超声造影对于单发的实性甲状腺结节性质的诊断价值。材料与方法:将80例经病理检查证实是甲状腺的单发实性结节,对于入组的患者先做常规的超声检查,然后做超声造影检查,观察结节的增强特征及时间-强度曲线定量参数,如达峰时间(Tp)、峰值强度(Peak)、曲线下面积(AUC)和平均造影剂通过时间(MTT),然后判断实性结节的良恶性。结果:经超声造影后,良性的甲状腺实性结节主要表现为均匀分布的造影剂、结节显著增强、边界清楚且形态规则;但是,甲状腺的恶性结节造影表现则恰恰相反,不均匀分布的造影剂、结节不明显增强、边界不清且形态不规则,有时还有到灌注缺损;良性结节与恶性结节在造影表现上差异有统计学的意义(P<0.05)。与常规超声相比,对良性结节超声造影检查在测量大小没有差异,但是对于恶性结节来说有差异(P<0.05)。恶性结节的Peak、AUC较良性结节低,Tp较良性结节延迟(P<0.05);而对MTT,在统计学上,两者的差异并没有意义。据甲状腺结节的病理检查结果,超声造影鉴别甲状腺良恶性结节的符合率为90%。结论:超声造影检查做为一种无创检查,对甲状腺结节良恶性的诊断价值较高。
OBJECTIVE: To discuss the diagnostic value of contrast-enhanced ultrasound in the diagnosis of solitary solid thyroid nodules. Materials and Methods: Totally 80 single solid nodules confirmed by pathology were thyroid gland. Conventional ultrasound examination was performed on patients before enrolling. Then ultrasound contrast examination was performed to observe the nodular enhancement characteristics and time-intensity curve Quantitative parameters such as peak time (Tp), peak intensity (AUC), and mean transit time (MTT) were used to determine the benign and malignant solid nodules. Results: The contrast-enhanced benign thyroid nodules showed uniform distribution of contrast agent after ultrasound contrast. The nodules were significantly enhanced with clear boundary and regular morphology. However, the malignant nodules of thyroid gland showed the opposite contrast with uneven distribution Of the contrast agent, nodules were not significantly enhanced, the boundary is unclear and irregular shape, and sometimes to perfusion defect; benign nodules and malignant nodules in the contrast of the performance was statistically significant (P <0.05). There was no difference in the size of the benign nodules compared with conventional ultrasound, but there was a difference in malignant nodules (P <0.05). Malignant nodules Peak, AUC lower than benign nodules, Tp delay than benign nodules (P <0.05); MTT, statistically, the difference between the two does not make sense. According to the pathological examination of thyroid nodules, ultrasound imaging of benign and malignant thyroid nodules in line with the rate of 90%. Conclusion: Contrast-enhanced ultrasound as a noninvasive examination has a high diagnostic value for benign and malignant thyroid nodules.