实时灰阶超声造影诊断良恶性甲状腺病变

目的探讨实时灰阶CEUS在鉴别诊断甲状腺良恶性病变中的价值。方法对45例甲状腺良恶性病变患者（共45个病灶）分别进行实时灰阶CEUS检查,分析病灶增强模式和血流灌注特征,并与病理结果进行对照。结果实时灰阶CEUS诊断甲状腺良性病灶31个,恶性病灶14个,诊断准确率分别为93.75%（30/32）和92.31%（12/13）。良性病灶中,27个（27/31,87.10%）呈整体均匀增强,4个（4/31,12.90%）呈不均匀增强;恶性病灶中,1个（1/14,7.14%）呈均匀低增强,12个（12/14,85.71%）呈不均匀高增强,1个（1/14,7.14%）无增强。结论二维灰阶声像图、CDFI结合CEUS动态观察甲状腺病灶的微血管灌注有助于鉴别诊断病变的良恶性。

Contrast-enhanced ultrasonic diagnosis of benign and malignant solid thyroid lesions

Objective To investigate the value of CEUS in differential diagnosis of benign and malignant thyroid solid lesions. Methods Totally 45 patients with thyroid solid lesions underwent CEUS examination. The enhancement mode and blood perfusion characteristics of malignant and benign lesions were analyzed, and the results were compared with pathology. Results CEUS diagnosed 31 benign lesions and 14 malignant masses. The diagnostic accordance rate of CEUS was 93.75% (30/32) and 92.31% (12/13) for benign and malignant lesions respectively. In 31 benign lesions, 27 (27/31, 87.10%) showed entire homogeneous enhancement, 4 (4/31, 12.90%) presented inhomogeneous enhancement. In 14 malignant masses, 1 (1/14, 7.14%) showed homogeneous hypoechoic enhancement, 12 (12/14, 85.71%) presented inhomogeneous hyperechoic enhancement and 1 (1/14, 7.14%) presented non-enhancement. Conclusion Combined with two-dimensional grey scale ultrasound and CDFI, CEUS enables dynamic observation of the microvascular perfusion of thyroid lesions, therefore helps to differentiate benign and malignant thyroid lesions.