超微血管三维立体成像评估甲状腺结节血流的临床应用价值

目的通过观察甲状腺结节的超微血管三维立体成像（Smart 3D SMI）声像图特征,探讨Smart 3D SMI评估甲状腺结节血流的应用价值。方法对2018年3月至2019年12月107例病人采用彩色多普勒CDFI、超微血管二维（2D SMI）和三维成像（Smart3D SMI）技术,观察结节的血管走行、血流空间分布等特征,通过Alder半定量分级、穿支血管及血管分布形态评估结节的血管灌注特征。结果Smart 3D SMI对甲状腺结节的血流评估优于CDFI,且良、恶性结节的血流分型差异有统计学意义（P<0.01）。三种方法对恶性结节穿入血管的评估:CDFI检测率为14.3%、2D SMI 25.4%、Smart 3D SMI 38.1%,Smart 3D SMI对穿支血管的检测率最高。根据血管分布评估,5枚良性结节:2D SMI检查为无血流类型,其中3枚Smart 3D SMI显示为外周型,2枚为混合型。2枚恶性结节:2D SMI检查均为无血流类型,其中1枚Smart 3D SMI示为穿入型,另1枚为中心型。结论Smart 3D SMI能够有效的甲状腺结节的微血管灌注特性,值得临床进一步推广和实践。

Clinical application value of smart three-dimensional superb microvascular imaging in the evaluation of thyroid nodule blood flow

ObjectiveTo observe the ultrasonic characteristics of smart three-dimensional superb microvascular imaging (Smart 3D SMI) in thyroid nodule, and explore the application value of Smart 3D SMI in the evaluation of thyroid nodule blood flow.MethodsFrom March 2018 to December 2019, 107 patients(107 nodules) were detected using the color Doppler Flow Imaging(CDFI), 2D SMI and Smart 3D SMI to observe the blood vessels line and blood flow spatial distribution of the nodules.The vascular perfusion characteristics of nodules were evaluated using Alder semi-quantitative classification, perforator vessels and vascular distribution morphology.ResultsThe blood flow evaluation of Smart 3D SMI for thyroid nodule was better than that of CDFI, and the difference of blood flow classification between benign and malignant nodule was statistically significant(P<0.01).The results of three methods in the evaluation of malignant nodules penetrating into blood vessels showed that the detection rates of CDFI, 2D SMI and Smart 3D SMI were 14.3%, 25.4%, 38.1%, respectively, and the detection rates of Smart 3D SMI was the highest.According to the vascular distribution assessment, there were 5 benign nodules.The results of 2D SMI showed that 5 benign nodules were blood flow type, and the results of Smart 3D SMI showed that 3 benign nodules were peripheral type, and 2 benign nodules were mixed type.Among 2 malignant nodules, the results of 2D SMI showed that 2 malignant nodules were no blood flow type, and the results of Smart 3D SMI showed that 1 malignant nodule was penetrating type, and 1 malignant nodule was central type.ConclusionsSmart 3D SMI has high clinical application value in the evaluation of the microvascular perfusion characteristics of thyroid nodule, which is worthy of further promotion and practice in clinic.