超声造影对甲状腺乳头状癌的增强模式探讨

目的 探讨甲状腺乳头状癌超声造影的增强模式,评价超声造影对甲状腺乳头状癌的诊断价值.方法 2007年1月至2008年10月浙江舟山医院超声科,应用微泡造影剂SonoVue及对比脉冲序列(CPS)造影成像技术对122例甲状腺占位性病变患者行检查,回顾性分析其中31例35灶甲状腺乳头状癌的超声造影增强表现.结果 35灶甲状腺乳头状癌造影后增强表现可分为3种模式:模式Ⅰ,病灶呈环状不规则缓慢向心性填充(23灶),但中心部分未见造影剂充填;模式Ⅱ,整体均匀性增强(5灶);模式Ⅲ,整体不均匀性增强(7灶).甲状腺良、恶性病灶灌注时间曲线相比较,甲状腺乳头状癌与结节性甲状腺肿相比较造影剂到达时间(AT)、达峰时间(TTP)和开始消退时间(WT)三项指标差异均有统计学意义(均P<0.05);甲状腺乳头状癌与甲状腺腺瘤相比较仅WT一项指标差异有统计学意义(P<0.05).结论 常规超声诊断困难的甲状腺癌超声造影后根据其典型增强模式,多数可作出明确的诊断.

Enhancement pattern of thyroid carcinoma with contrast-enhanced ultrasound

Objective To investigate the enhancement pattern of thyroid carcinoma with contrast-enhanced ultrasound (CEUS) for the diagnostic value. Methods Thirty-one cases with thirty-five thyroid Occupied were retrospectively reviewed. The final diagnosis was confirmed by biopsy pathology. Contrast agent SonoVue and contrast pulse sequencing (CPS) technique were used in this study. Results Thirty-five thyroid carcinoma presented three enhancement patterns with CEUS. Type I : twenty-three lesions enhanced in a pattern of ring with centripetal fill-in,however, the central part of no contrast agent filling . Type Ⅱ : five lesions enhanced regularly and homogeneously . Type Ⅲ: seven lesions enhanced irregularly and homogeneously. Thyroid benign and malignant lesions perfusion time curve, compared to papillary thyroid carcinoma with nodular goiter in the AT, TTP and WT indicators P <0. 05 ; papillary thyroid carcinoma and thyroid adenoma, compared to WT alone an indicator of P < 0.05. Conclusions Identification of the different enhancement patterns of thyroid carcinoma could improve the diagnostic ability of CEUS.