甲状腺囊性皱缩结节的超声表现及造影特点

目的 探讨甲状腺囊性结节皱缩后极低回声结节高频超声及超声造影的特点。方法 回顾性分析35例经细针穿刺细胞学证实为甲状腺机化囊肿,并6个月随访无增大的甲状腺结节,及40例经细针穿刺或手术证实的极低回声甲状腺微小乳头状癌(最大径小于1cm)的超声表现和超声造影检查特点,比较分析二者边界、钙化、纵横比等超声特点及超声造影表现。结果 在两组极低回声结节中,结节纵横比、是否存在环状或半环状钙化以及超声造影内部增强特点方面存在显著差异(P < 0.05)。其中纵横比小于1、环状或半环状钙化和造影表现为整体无增强是囊性皱缩结节的特征表现,而纵横比大于1和造影表现为低增强则是甲状腺乳头状癌的特征。结论 甲状腺囊性结节吸收皱缩机化后声像图呈极低回声表现,易被误诊为恶性结节,但通过结节的纵横比、是否伴有环状或半环状钙化及超声造影的特征性表现可以加以区分,因此超声及超声造影在鉴别诊断甲状腺囊性皱缩机化结节及甲状腺乳头状癌方面具有重要的意义。

Ultrasound and contrast-enhanced ultrasound characteristics of shrinking thyroid cystic nodules

Objective To investigate the features of thyroid cystic nodules after absorption and contraction of cystic fluid in high-frequency ultrasound and contrast-enhanced ultrasound(CEUS). Methods Thrity-five cases of thyroid organized cysts were confirmed by fine needle aspiration cytology, with preoperative high-frequency ultrasound and contrast-enhanced ultrasound. Forty cases with markedly hypoechoic nodules were all papillary thyroid carcinoma(with a maximum diameter of less than 1 cm) confirmed by fine needle aspiration or surgery. The two groups both performed with retrospective analysis of the boundary, calcification, and taller-than-wide ratio and characteristics of contrast-enhanced ultrasound. Results There were significant differences in taller than wide ratio, calcification, and internal enhancement in CEUS between the two groups of markedly hypoechoic nodules (P < 0.05). Taller-than-wide ratio less than 1, the annular or semi-annular calcification, and overall no enhancement in CEUS was features of wrinkled cystic nodules, while taller-than-wide ratio greater than 1 and low enhancement in CEUS are characteristics of malignant tumors. Conclusion The ultrasonic features of thyroid cystic nodules with cyst resorption are similar to the markedly hypoechoic malignant nodules. In the markedly hypoechoic thyroid nodules with a maximum diameter of less than 1 cm, taller-than-wide ratio, the annular or semi-annular calcification of the nodules, and features in contrast-enhanced ultrasound are used to identify the two kinds of markedly hypoechoic nodules. Ultrasouond and CEUS have great significance in differential diagnosis of shrinking thyroid cystic nodules and markedly hypoechoic papillary carcinoma.