超声造影与增强CT鉴别诊断良恶性甲状腺结节

目的 对比超声造影（CEUS）与增强CT鉴别诊断良恶性甲状腺结节的价值。方法 纳入179例甲状腺结节患者、共229个结节，根据结节性质分为良性组（n=83）和恶性组（n=146）；观察结节CEUS和增强CT特征，以病理结果为金标准，对比2种影像学方法鉴别诊断良恶性甲状腺结节的效能。结果 良、恶性组甲状腺结节CEUS增强强度、增强模式及有无环绕增强差异均有统计学意义（P均<0.05）；增强CT强化特点、边缘情况、甲状腺边缘有无中断及钙化性质差异亦均有统计学意义（P均<0.05）。CEUS诊断甲状腺良恶性结节的敏感度、特异度及准确率分别为89.73%、78.31%及85.59%；增强CT诊断分别为78.08%、71.08%及75.55%。结论 CEUS和增强CT鉴别甲状腺良恶性结节均有一定价值；CEUS的诊断效能总体优于增强CT。

Contrast-enhanced ultrasound and enhanced CT in differential diagnosis of benign and malignant thyroid nodules

Objective To compare the value of contrast-enhanced ultrasound (CEUS) and enhanced CT in differential diagnosis of benign and malignant thyroid nodules. Methods A total of 179 patients were enrolled, including 229 nodules thyroid nodules, which were divided into benign group (n=83) and malignant group (n=146). CEUS and enhanced CT characteristics of benign and malignant thyroid nodules were observed. Taken pathological results as the gold standards, the efficacy of CEUS and enhanced CT for differential diagnosis of benign and malignant nodules were evaluated. Results CEUS enhancement intensity, enhancement mode and surrounding enhancement of thyroid nodules were all statistically different between benign and malignant groups (all P<0.05). The enhancement characteristics, edge conditions, interrupted thyroid edge and the nature of calcification of thyroid nodules showed on enhanced were also significantly different between benign and malignant groups (all P<0.05). The sensitivity, specificity and accuracy of CEUS for diagnosing benign and malignant thyroid nodules was 89.73%, 78.31% and 85.59%, respectively, of enhanced CT diagnosis was 78.08%, 71.08% and 75.55%, respectively. Conclusion Both CEUS and enhanced CT had certain value in differentiating benign and malignant thyroid nodules. The diagnostic efficiency of CEUS was generally better than that of enhanced CT.