常规超声及超声造影在甲状腺良恶性结节中的鉴别诊断价值

目的探讨甲状腺良恶性结节的常规超声特征、超声造影表现及其鉴别诊断价值。方法对206例甲状腺结节患者(共计227个结节)术前行常规超声及超声造影检查,根据术后病理结果对其常规超声征象及超声造影表现进行良恶性对照研究。结果常规超声诊断准确率83.04%,其中恶性结节在结节边界、形态、内部及后方回声、纵横比、钙化灶等方面与良性结节比较差异有统计学意义(P0.05);恶性结节血流阻力指数(0.73±0.15)明显高于良性结节(0.61±0.09),差异有统计学意义(P0.05)。超声造影诊断准确率85.02%,甲状腺恶性结节以不均匀增强、早达峰为主,在增强模式及达峰时间方面与良性结节比较差异均有统计学意义(均P0.05);良恶性结节造影前后最大径线比较差异无统计学意义。结论常规超声及超声造影对甲状腺结节良恶性鉴别均具有临床应用价值,对于常规超声难以鉴别的结节可联合超声造影进行综合诊断。

Value of conventional ultrasound and contrast-enhanced ultrasound in differential diagnosis of benign and malignant thyroid nodules

Objective To investigate the conventional ultrasound and contrast-enhanced ultrasound（CEUS） features of thyroid nodules and to evaluate the value in differential diagnosis of benign and malignant thyroid nodules. Methods Two hundred and six patients with 227 thyroid nodules underwent conventional ultrasound and CEUS examination before the operation, the features between benign and malignant nodules were comparely analyzed based on postoperative pathologic results. Results The diagnostic accuracy rate of conventional uhrasound was 83.04%, and the boundary, shape, internal and rear echo, aspect ratio, calcifications were statistically different between malignant and benign nodules （P〈0.05）; the blood flow resistance index of malignant nodules（0.73~0.15 ） was significantly higher than that of benign nodules （0.61：i：0.09）, and the difference was statistically significant（P〈0.05 ）. The diagnostic accuracy rate of CEUS was 85.02%, malignant thyroid nodules showed heterogeneous enhancement, most of early peak,the enhancement pattern and the time to peak in malignant nodules were statistically different from benign nodules （P〈0.05）; the largest diameter before and after contrast had no statistical significance between the benign and malignant thyroid nodules. Conclusion Conventional ultrasound and CEUS are valuable in clinical identification between benign and malignant thyroid nodules. The combination of CEUS and conventional uhrasound may be useful for nodules which are difficult to identify with conventional ultrasound alone.