甲状腺腺瘤超声造影特征与病理微血管密度相关性

目的探讨甲状腺腺瘤的超声造影增强特征,分析超声造影定量参数与微血管密度的相关性。方法 30例甲状腺腺瘤患者行超声造影,采用TomTec软件对甲状腺腺瘤组织（腺瘤组）与周围正常甲状腺组织（对照组）绘制时间-强度曲线,比较2组超声造影定量参数始增时间、达峰时间、最大峰值强度与平均渡越时间。腺瘤组采用免疫组织化学方法进行微血管密度计数,并与超声造影定量参数进行相关性分析。结果 29例甲状腺腺瘤表现为高增强,1例表现为等增强,以均匀增强为主;腺瘤组始增时间、达峰时间（（14.1±3.5）、（20.5±5.9）s）低于对照组（（15.1±3.8）、（22.6±6.6）s）,最大峰值强度（（166.6±37.0）%）高于对照组（（100.0±0.0）%）（P〈0.05）,平均渡越时间（（32.4±7.9）s）与对照组（（34.4±8.7）s）比较差异无统计学意义（P〉0.05）;免疫组织化学染色结果显示腺瘤组微血管丰富,始增时间、达峰时间、平均渡越时间与微血管密度呈负相关（P=0.000）,最大峰值强度与微血管密度呈正相关（P=0.000）。结论甲状腺腺瘤微血管丰富,超声造影增强模式多表现为高增强,超声造影定量参数与微血管密度有一定相关性。

Relationship between contrast-enhanced ultrasound characteristics and microvessel density of thyroid adenoma

Objective To investigate the contrast-enhanced ultrasound（CEUS）characteristics of thyroid adenoma and analyze the relationships between CEUS quantitative parameters and microvessel density（MVD）.Methods CEUS was performed in 30 patients with thyroid adenoma.The time-intensity curve（TIC）of thyroid adenoma and normal thyroid tissue was drawn by TomTec software to compare the rise time（RT）,time to peak（TTP）,maximum intensity（IMAX）and mean transit time（mTT）.Immunohistochemical method was performed to evaluate MVD and analyze the quantitative parameters of CEUS in thyroid adenoma tissue.Results Twenty-nine patients with thyroid adenoma showed hyperechoic and one showed isoechoic,mainly enhancing homogeneously.RT and TTP were shorter,and IMAX was higher in thyroid adenoma tissue（（14.1±3.5）s,（20.5±5.9）s,（166.6±37.0）%）than those in normal thyroid tissue（（15.1±3.8）s,（22.6±6.6）s,（100.0±0.0）%）（P0.05）.There was no significant difference in mTT between thyroid adenoma tissue（（32.4±7.9）s）and normal thyroid tissue（（34.4±8.7）s）（P0.05）.Immunohistochemical staining showed rich microvessel in thyroid adenoma tissue.RT,TTP,mTT and MVD were negatively correlated,and IMAX was positively correlated with MVD（P=0.000）.Conclusion Microvessel is rich in thyroid adenoma tissue.Hyperechoic is the important CEUS enhancement patterns of thyroid adenoma.CEUS parameters are correlated with MVD.