超声造影不均匀低增强对甲状腺乳头状癌的诊断价值

目的:探讨超声造影（CEUS）不均匀低增强对甲状腺乳头状癌的诊断价值。方法:选取2015年2月至2017年2月于延安大学附属医院行甲状腺手术并于术前行超声造影检查的患者，回顾性分析，将增强模式表现进行分类，并与病理结果进行对照。结果:72例患者共74个结节。不均匀低增强43个结节，其中31个乳头状癌，9个结节性甲状腺肿，2个桥本氏甲状腺炎，1个髓样癌；超声造影不均匀低增强诊断甲状腺乳头状癌的敏感性、特异性及准确率分别为86.11%(31/36)、68.42%(26/38)和77.03%(57/74)。结论:超声造影诊断甲状腺乳头状癌具有其独特的优势，但是仅仅依靠“不均匀低增强”诊断PTC存在较高的误诊率，所以诊断过程中还应注意结节增强后的边界、形态及甲状腺包膜完整性等观察指标。

The efficiency of the low and nonhomogeneous enhancement-pattern by CEUS in the diagnosis of PTC

Objective:To investigate contrast-enhanced ultrasound heterogeneous low enhancement for diagnosis of thyroid papillary carcinoma.Methods:Patients with thyroid surgery and preoperative ultrasound examination in Affiliated Hospital of Yan'an University from February 2015 to February 2017 were selected.Performance enhancement pattern was classified,and pathological results with compared.Results:A total of 72 patients with 74 nodules，the nodules are nonhomogeneous and low enhancement in 43 nodules,including papillary carcinoma 31 nodules,nodular goiter 9 nodules,hashimoto's thyroiditis 2 cases and medullary carcinoma 1 nodule.The diagnostic sensibility,specificity,and accuracy of the nonhomogeneous and low enhancement-pattern by CEUS were 80.56%(29/36),76.32%(29/38)and 78.38%(58/74).Conclusion:Our results prove that contrast-enhanced ultrasound has its unique advantages in diagnosing the PTC，but just rely on "nonhomogeneous and low enhancement"to diagnose the PTC still exists high misdiagnosis rate.So,during the process of diagnosing thyroid nodules,we also should pay attention to the additional observations,such as the border,structure,and the integrity of capsular after enhancement.